0 



A 



TREATISE ON THE PLAGUE. 



" La peste, uno dei piu terribili mali che possano affligere il genere umano, benche 
non sia propriamente lo stesso che il contagio, pure suole aver fra noi il nome di con- 
tagio per che toccari i corpi, o l'aria degli appestati, o le merci, o robe, loro, se ne 
infettano i sani, con pin forza e strage, che non accade in altri morbi epidemici e attac- 
catici — il perche contagio suo l'anche appellarsi la peste."— Muratori dkua Peste. 



" Pallida mors equo pulsat pede pauperum tubernas regurnque turres."— Virgil. 



TREATISE ON THE PLAGUE 



MORE ESPECIALLY ON 



THE POLICE MANAGEMENT 

OF 

THAT DISEASE. 

ILLUSTRATED BY THE PLAN OF OPERATIONS SUCCESSFULLY 
CARRIED INTO EFFECT IN THE LATE 

3Plapt> of <&oxi\\. 
WITH HINTS ON QUARANTINE, 

BY 

A. WHITE, M.I). 

DEPUTY INSPECTOR-GENERAL OF MILITARY HOSPITALS, AND LATE SUPER- 
INTENDENT OF THE PLAGUE IN CORFU, 
AND FELLOW OF THE ROYAL COLLEGE OF SURGEONS IN LONDON. 




LONDON: 

JOHN CHURCHILL, PRINCES STREET, SOHO. 

MDCCCXLVI. 



TO 



SIR JAMES M'GRIGOR, BART. 

DIRECTOR-GENERAL OF THE AH MY MEDICAL DEPARTMENT, 
&C. &C. &C. 



Sir, 

I have the honour to dedicate to you the following- 
Work on the Plague, which treats more especially of that 
which prevailed in Corfu in 1816, when the Plague District of 
Lefchinio was placed under my superintendence by the late 
General Sir Thomas Maitland, then Lord High Commissioner 
of the Ionian Islands. 

And I do this with more pleasure, because you are the 
oldest of my medico-military acquaintances under whom I 
served, many years since, in Egypt, on the same duty. 

At that time, almost all the medical officers of the Egyptian 
army were of opinion that Plague was a contagious disease, 
and the fomes of it capable of being transported from place to 
place. 

The Plague in Corfu has, I think, sufficiently proved the 
contagious character of this disease, from its first introduction 
into that island, to its final suppression : since which period 
no plague has appeared there. 

I have also demonstrated what may be achieved, under very 
trying and discouraging circumstances, by an efficient, well- 



vi 



DEDICATION. 



regulated Police Establishment, in forcibly crushing, and finally 
extinguishing, in a very short time, this formidable malady, 
which seems to carry with it a peculiarity of character that 
renders it distinct from all other diseases with which we are 
acquainted. 

In the Plague which appeared in Cephalonia, about the 
same time, and the introduction of which was attributed to the 
same cause — viz., smuggling, — a similar vigorous management 
by police restraint was adopted, and with equally happy effects. 

That the Laws of Quarantine require modification, I admit ; 
but that they should be abrogated and overturned with im- 
punity, as useless, I cannot too strongly deprecate ; for my 
strongest conviction is, that in doing away with these laws alto- 
gether, our commerce would be restricted rather than enlarged, 
and this sad calamity would, sooner or later, find its way to 
our shores. 



The Author. 



CONTENTS. 



PAGE 

Preface v 

Introductory Discourse 1 



PART I. 



ON THE NATURE AND QUALITIES OF PLAGUE. 



CHAPTER I. 

Diversity of opinion respecting plague — Considered a disease depending 
on contagion — Persons, however, sometimes escape it, though in close 
contact with plague-patients — Ancients of the opinion that plague is 
contagious — The word plague used indefinitely by them — They were 
unable to account for its introduction into a place — This circumstance 
explained by moderns on the principle of contagion — The true plague 
well known to the ancients — They were aware of its being propa- 
gated by intercourse with the sick, though probably not, that it could 
be introduced by persons or effects coming from a distant place where 
plague was raging 55 



CHAPTER II. 

The Jewish Legislator acquainted with contagion, and aware that disease 
was propagated thereby — In aggravated cases, Moses directs the gar- 
ments to be burned, and the houses to be purified — Modern writers of 
the same opinion as to plague — Plague effluvia considered — How in- 
troduced into the system — Inoculating for the plague 64 



PART II. 

ON THE ORIGIN AND HISTORY OF THE PLAGUE, WITH AN 
ACCOUNT OF ITS SYMPTOMS AND PROGNOSIS. 



CHAPTER I. 

Egypt supposed to be the focus of plague — The diffusion of plague ascribed 
to preternatural phenomena, meteors, earthquakes, hurricanes, &c. — 
Plague an imported disease — It excited much attention about the time 
of the Crusades — Precautionary measures adopted against it about the 



viii 



CONTENTS. 



same period — How quarantine laws came to be established, and gradually 
perfected — The exemption of Europe ascribed to these laws — Dreadful 
effects of fatalism among the Mahometans — Differently evinced among 
them and Christians — Fatalism on the decline in Turkey — The malady 
capable of being diminished, if not entirely expelled from plague 
countries — for instance, from Turkey in Europe, — unless owing to local 
causes, which cannot be removed or controlled — Doubts whether or not 
the plague is indigenous in Turkey in Europe — Policy of the Ottoman 
Porte with respect to plague — Quarantine laws, if successful in ex- 
pelling the plague from civilized Europe, why should they not be so in 
expelling it from Turkey in Europe — Plague continuous there — 
Introduction of plague into civilized Europe attributed to imported 
contagion 71 



CHAPTER II. 

Plague imported by sea — Shown to be an imported disease by its being 
suppressed in lazarettos — Plague also imported by land — Gene- 
rally accompanying the Mahometan armies— Thus traced to Jassy, 
Moscow, &c 82 



CHAPTER III. 

The Franks escape by shutting up — Plague most destructive in crowded 
places, and among the attendants on the sick — The Foundling Hospital 
in Moscow! preserved by the jealous care of De Mertins, in keeping it 
insulated— /-Danger of permitting intercourse with, and of receiving 
strangers in the time of plague 85 

CHAPTER IV. 

The plague not communicable, like epidemic diseases, through the medium 
of the atmosphere — The efficacy of well-regulated cordons, as a 
security against the malady, as seen in Lefchimo — The sense of danger 
a good preservative — The foolhardy and those who violated the laws 
of quarantine the sufferers — Persons impested sometimes unconscious 
of their being so 89 



CHAPTER V. 

Sad consequences of dilatory measures on the breaking out of plague — 
Necessity of choosing for the management of plague-matters men of 
practical experience and integrity— Necessity of liberally rewarding 
and placing above temptation persons in plague-service — Danger of 
being thrown off our guard by the lulling or apparent cessation of the 
malady — Plague not so regular in its periodical visitations as has been 
supposed — Prevailing notion of the Franks on this subject — In plague 
countries, the malady is not always in the same state of activity at the 



CONTENTS. 



ix 



same periods— Is not affected by extremes of heat and cold— These 
may, however, modify its type — Any supposed benefit arising from 
these extremes not to interfere with the plan of management for sup- 



pressing the calamity 92 

CHAPTER VI. 

Suddenness of the attack of plague exemplified . . . 98 

CHAPTER VII. 



Pestilential contagion usually very violent at the beginning : occasionally 
so during its course — March of the plague — Inquiry how it has been 
introduced : often by means of contraband goods, or mismanagement 
in health-offices — Great advantage of the early application of the 
proper remedies in suppressing it exemplified in Cephalonia — The 
general principles for its suppression always the same — Separation 
and segregation— Difficulties to be encountered in arranging the 



classifications 103 

CHAPTER VIII. 

The necessity of shutting up on plague being proclaimed* — Of avoiding 
all intercourse, and of impressing this on the public mind — Several of 
the people of Lefchimo guilty of violating the laws— Indisposition 
during the period of quarantine .115 

CHAPTER IX. 

Plague-contagion considered as capable of being transported from place 
to place — Has been imported into England — May be so again— Mer- 
chants anxious to have quarantine restraints removed .120 



CHAPTER X. 

Safest, and perhaps in some circumstances cheapest, to destroy a plague- 
ship at once, rather than to expurgate her — The health of a ship's 
crew not sufficient proof that there is no plague-contagion on board — 
Indemnification from governments for impested property destroyed — 
Impossibility sometimes of ascertaining at once whether a ship has the 
plague on board or not — Such ship should not be allowed pratique 
until that point is ascertained — Manner in which goods may be im- 
pested — The plague said not to proceed in an easterly direction — Is 
probably influenced by season — Uncertainty of the period plague- 
contagion may retain its activity — Modification or relaxation of the 
quarantine laws of England — Why expurgators in England have so 
long escaped the plague — Dealers in old clothes said not to contract 
the plague 125 



X 



CONTENTS. 



CHAPTER XI. 

PAGE 

On the symptoms of the plague — The supposed characteristic symptoms 
sometimes absent — Collateral circumstances to be considered in order 
to enable us to decide on its actual existence — Symptoms of the cele- 
brated plague mentioned by Procopius — Of that which attacked the 
British army in Egypt — Of that in Lefchimo — Of the prognosis . .135 

CHAPTER XII. 

On re-infection and relapse 151 

PART III. 

NARRATIVE OF THE PLAGUE OF LEFCHIMO; ITS 
INTRODUCTION AND PROGRESS. 

CHAPTER I. 

Short account of the plague district — Subject to autumnal remittent 
fevers — Introduction of the plague into Lefchimo 154 

CHAPTER II. 

Propagation of the calamity in the upper district — First in the village of 
Marathea — Mr. Tully sent to inquire into the sickness prevailing 
there — Did not consider it to be the plague — Measures of restraint 
entered upon — The sickness superstitiously imputed to an evil spirit — 
Propagated by the priests in the villages of Perivoli and Anaplades — 
In Argirades — Troops sent into the district — Also medical officers — 
Melancholy occurrence among the troops from a violation of quaran- 
tine — Propagation of the calamity in the village of Rumanades — In 
Neocori — In Cuspades — In Clomo — Another distressing occurrence 
among the troops from a violation of quarantine — Saint Dimitri im- 
pested — Also Critica — The other villages of Upper Lefchimo not im- 
pested — Necessity of some restraint in places not impested — Want of 
confidence necessarily existing in the time of plague .158 

CHAPTER III. 

Propagation of the plague in Lower Lefchimo — Saint Theodoro impested 
— Also Melechia — People anxious to conceal indisposition in the time 
of plague — A pest hospital ought not to be established in a town if it 
can possibly be avoided — Cruelty and inexpediency of burning im- 
pested houses — Removal of the susceptible effects from impested 
houses — Effects of persons simply suspected — Permission granted in 
Lefchimo to the class of simply suspected to take their effects along 
with them to the camps — Punishments sometimes necessaiy . . . 1 74 



CONTENTS. 



xi 



PART IV. 



PLAN OF MANAGEMENT IN THE PLAGUE OF LEFCHIMO. 



CHAPTER I. 

PAGE 

Concentration of the sick and suspected — The district divided into com- 
partments, and no intercourse allowed between them— Mischief arising 
from not attending to the regular shutting-up of camps — Medical in- 
spections in the impested villages— The people unwilling to submit to 
them — In ordinary indisposition, the people allowed to remain in their 
houses, and receive medical attendance there — Good effects of these 
measures — Felons employed in duties where there is the most danger — 
Persons once recovered from plague not likely to be attacked by it 
again — Advantages of employing convalescents from plague in the 
most dangerous duties 184 

CHAPTER II. 

On expurgation — Examination of the impested houses — Purification of the 
impested houses — Removal of the depots of impested things to a 
general depot — Valuation of the effects sent to this depot — Burning 
of the depot resolved on — And carried into execution 192 

CHAPTER III. 

Expurgation of the churches— Securing the plague graves — Concealed 
effects — Rewards granted for their discovery — Duties of the medical 
officer in charge of the camps, or places of segregation — The length 
of time plague contagion may remain in the system without showing 
itself .202 

CHAPTER IV. 

On camps — The provisions to be placed at a particular spot — Difficulty of 
sometimes ascertaining what property ought to be expurgated and 
what should not be interfered with — Prevailing opinion in Lefchimo 
concerning property destroyed there 213 



CHAPTER V. 

Removal of the people in the camps to their villages — Great difficulty of 
provisioning the people — Sir Thomas Maitland's kind consideration 
for them — Necessity of bringing matters to a speedy termination on 
account of the expected remittent fever — The people's houses to be 
repaired before they are sent home — Some of the persons, very weak 
from ordinary complaints, to be removed — Minute examination of 



xii 



CONTENTS. 



all the people previous to their removal — Necessity of employing civic 
guards to assist the troops — Reasons for subjecting the persons re- 
turned from the camps to further quarantine — Great joy of the people 
on being liberated — Further means adopted to discover concealed 
effects — Highly improper conduct on the part of the priests — The 
people who were hitherto shut up in their villages, liberated before 
those belonging to them were sent back from the camps — Period of 
quarantine in the class of highly suspected shortened from forty to 
twenty-five days, that of the class of simply suspected from forty to 
seventeen days — On cases of supposed plague — The difficulty of 
managing individual convalescents from plague — On the pestilential 
bubo — A place of security to be prepared for the performance of the 
quarantine of convalescents from plague — Examination of these pre- 
vious to their being encamped — Are to be well washed and receive 
fresh clothes — Those of Lefchimo directed to give up any effects they 
may have concealed — Amulets worn . by several of them, to which they 
attributed their recovery ...217 

CHAPTER VI. 

The people returned from the camps unwilling to occupy their houses— 
Not fewer than three persons supposed sufficient to prove an impested 
house — Considerable anxiety whilst such proofs were going on — The 
people now remaining in the camps permitted to draw supplies from 
their villages — The corps of expurgators diminished — Directions to 
the medical officers whenever sickness should occur in the district — 
The people permitted to pull their flax, but not to steep it for the pre- 
sent — A discovery of concealed goods made by accident — An alarm of 
plague in Marathea — Craftiness and ingratitude of certain inhabitants 
of Lefchimo 236 



CHAPTER VII. 

On congregations of people in the time of plague — Certificate of the 
health of Lefchimo — Free pratique proclaimed within the district it- 
self, but not between it and the rest of the island — Dissensions respect- 
ing property among the people of Lefchimo — The pest hospital 
broken up — The troops at the principal cordon very sickly from the 
remittent fever — Another alarm of plague in the village of Cuspades — 
The first fortnight of a general pratique always a critical period — Short 
account of the autumnal fever in Lefchimo — A case of sudden death 
from apoplexy — Necessity of withdrawing the troops from the villages, 
on account of the sickness among them 248 

CHAPTER VIII. 

Expurgation of the pest hospital — Urgent necessity, on account of the 
sickness among the troops, of speedily winding up the plague matters — 



CONTENTS, 



xiii 



PAGE 

The quarantine of the convalescents diminished from eighty to fifty- 
days — They are not placed under restraint on their return home, as 
had been done with the suspected — Those who died of the prevailing 
fever not buried until the bodies were examined— The pest hospital 
proved as the other plague houses had been — All quarantine restraints 
removed, and the district of Lefchimo placed in free pratique with the 
rest of the island- — Some troops, and several medical gentlemen left for 
a short time in the district 262 

PART V. 
ON THE CURE OF THE PLAGUE. 

Bleeding — Cold bathing — Diaphoretics — Emetics — Purgatives — Cor- 
dials — Opium — Saline mixtures — iEther — Camphor — Mercury — 
Blisters— Poultices— Bark 276 



Conclusion 295 

Appendix 307 

Notes 335 



PREFACE. 



I had already committed to writing the following observations 
on the plague, without having fully made up my mind to pub- 
lish them, when a work appeared on the same subject by Mr, 
Tully, surgeon to the forces ; in which he treats, like myself, of 
the particular plague of Corfu. On perusing his work, I could 
not help thinking it defective in two essential points, — namely, 
in the description of the extension of the calamity from place to 
place, and in the detail of the police treatment adopted on the 
occasion. The latter defect was probably owing to his want of 
official documents, which, from the time I took the charge, were 
all in my possession ; and it was impossible for any one from 
memory alone to give in a regularly detailed form the pro- 
ceedings which took place in Lefchimo. 

Had Mr. Tully's work appeared to me sufficiently explicit on 
the two important points I have mentioned, it is not pro- 
bable that my observations on the same identical subject would 
have ever seen the light, especially as we perfectly agree in the 
opinion, that the plague is a disease depending on contagion 
alone, and as we both equally appreciate the advantages to be 
derived from a well organized and efficient police, in not only 
arresting the progress of the disorder, but in suppressing, and 
finally extinguishing it: on which last point I have dilated 
more than is usually done in a work of this kind, from my full 

B 



vi 



PREFACE. 



conviction that more is to be achieved by proper police towards 
diminishing and subduing the plague, than has ever yet been 
done by any medical treatment. 

But while this imperfection in the details of Mr. Tully's 
work operated as a powerful inducement with me to give my 
observations to the public, from the minuteness of which, at 
least, I presume some benefit may be derived in the future 
management of plague, another somewhat singular, though 
evidently a designed omission in the same work, in some degree 
compels me, however reluctantly, to obtrude myself upon the 
public as an author. Mr. Tully, in his work, has studiously 
concealed the circumstance of his having but acted under my 
orders for the greater part of the time in the plague of Lef- 
chimo ; and has carefully avoided so much as once mentioning 
my name, from first to last. Whatever were his motives for 
making such an omission, no one, I believe, will ascribe them 
either to modesty or candour. 

Far be it from me to detract from Mr. Tully's merits in the 
plague service. On the contrary, I feel much pleasure in 
acknowledging him to have been a most zealous and active 
officer. It is, however, but justice to others, as well as myself, 
to state what really was the position he held. 

In order to place Mr. Tully's merits and claims in their 
proper light, — a subject which I should not have thought of 
meddling with, had I not felt it incumbent upon me to do so in 
self-defence, — it is necessary for me to say, that on my arrival 
in Corfu with Major-General Sir Charles Phillips, after the 
army of the Mediterranean had been broken up in the month of 
March, 1816, his Excellency Sir Thomas Maitland, the Lord 
High Commissioner of the Ionian Islands, appointed Major- 
General Phillips to the supreme direction of the plague duties, 
and myself to the superintendence of the plague district ; con- 
sequently, to the immediate charge of the executive within that 
district : and in a few days afterwards, I was put in the general 
orders of the army as such, as will be seen by an extract from 



PREFACE. 



vil 



them, signed by Lieut-Colonel Jordan, Deputy Adjutant Ge- 
neral, a copy of which I subjoin : — 

(Letter I.) 

Adjutant- General's Office, 
General Order, No. 8. Corfu, March 23, 1816. 

Staff- Surgeon White will repair to Egrippos, to take charge of the plague 
district. 

(Signed) John Jordan, 

Dep. Adj. Gen. 

In virtue of this, I was of course to supersede Mr. Tully in 
every charge and responsibility ; and, in fact, I did so from the 
moment I went down to the plague district. This was not done 
in a corner, but in the face of the whole army, and indeed of 
the whole population of the island. Mr. Tully knows full well 
that his authority ceased from the time I went down to Lefchimo, 
which was a few days after my appointment : and, in taking 
that charge upon me, he also knows that I became the only 
organ of correspondence with the government relative to all 
matters of plague. 

It is not for me to enter upon the reasons which induced his 
Excellency General Sir Thomas Maitland to supersede Mr. 
Tully and to appoint me to the charge ; but had they not been 
good and substantial ones, I am very sure I should not only not 
have been called upon, but that I should not have been per- 
mitted to interfere in any way, even had I wished to do so. 

Yet, with a knowledge of these facts, and knowing also that, 
on whatever part of the service he was detached, it was his duty 
to report to me, as his superior, every transaction, — which, had 
he failed to do, must have been considered a breach of military 
orders, for which he would have been held responsible^ — he 
makes it appear that he was the only individual in authority on 
the occasion. 

It has no doubt frequently happened that superior officers 
have taken credit to themselves for the exertions of those 
serving under them, without bestowing on the individuals 

B 2 



viii 



PREFACE. 



who assisted them that commendation to which they were fairly 
entitled ; but I believe it is very uncommon for a writer to enter 
largely on a subject, and that regarding an important service, 
on which he had been employed, without once mentioning the 
name of the superior officer under whom he was serving for the 
greater part of the time, and to whom he was almost daily 
transmitting his reports. 

In both my public and private dispatches, I always spoke 
favourably of Mr. Tully ; and I think he will not deny that, 
during the time he served under my orders, I made his duty as 
pleasant to him as any duty of the kind could well be made. 
As the omission of my name in his work is calculated to mislead 
certain individuals whose esteem I value, and to affect my 
character with the army medical board, I owe it to myself in 
particular, and to the medical officers employed with me in 
general, to declare that all concerned were uncommonly zealous 
and active in the suppression of the malady, and that a degree 
of unanimity, together with the most unremitting and inde- 
fatigable exertion, pervaded all ranks, which, perhaps, has 
seldom been equalled on a similar occasion, and could not well 
be surpassed. 

I trust, therefore, that it will not be construed into egotism 
on my part merely to mention, that my own personal exertions 
have been commended by the Lord High Commissioner; by 
Major- General Sir Charles Phillips, under whose immediate 
orders I served ; and by the Senate of Corfu ; as also that the 
government has in some degree rewarded me for them, by con- 
firming to me, at the recommendation of the Director-General, 
a step of promotion I formerly held at the fall of Genoa, on 
which occasion I was employed as the second medical officer 
on that service. I here subjoin the letters referred to. 



PREFACE. 



ix 



(Letter II.) 

Copy of a Letter from Sir Frederick Hankey, public and private Secretary to 
the late Lieut.- General Sir Thomas Maitland, Lord High Commissioner 
of the Tonian States, to Dr. A. White, Superintendent of the Plague in 
Corfu. 

Brighton, 3rd December, 1841. 

Dear Sir, — I have received your letter, in which you request me to bear 
testimony in respect to your services in the plague of Corfu in 1816. 

I have retired from public service ; and therefore, generally speaking, ab- 
stain from meddling with public affairs ; nevertheless, in justice to you, I 
will do what you ask ; and having been the public and private Secretary to the 
late Lieut. -General Sir Thomas Maitland during the whole period of his 
administration, as the Lord High Commissioner in the Ionian States, I trust 
that I shall not be deemed presumptuous in saying what follows in the matter 
in question. 

Sir Thomas Maitland landed in Corfu in February, 1816. He was aware 
that previously, for two or three months, there had existed in the district 
of Lefchimo, in the south-eastern part of the island, a disease : it was called 
fever. However, Sir Thomas having examined into details, at once pronounced 
it to be plague, and made proclamation accordingly. 

He had great experience in matters of plague. He was, as you know, 
a man of singular firmness, and, I will venture to say, more fitted in every 
respect and for the emergency than almost any other man in the world. He 
proceeded on the principle that plague was only to be checked by preventing 
contact, and he cut off all communication between the infected district and the 
city of Corfu, by the active agency of the troops ; and he then adopted the 
most efficient measures in the district of Lefchimo to extirpate the disease ; 
all founded on the same principle of preventing contact. The result was, 
that he saved the island ; the plague never appeared in the city of Corfu, 
and was soon extinguished in the infected district, out of which it never 
escaped. In that district, you were employed as the principal medical officer; 
and I well know that he was perfectly satisfied with your conduct throughout. 
The mortality was great ; for the malady was, as I have said already, plague 
in its most violent form. But it was conquered by the establishment of 
infected and suspected camps, the whole of which were under your personal 
care, and your duties were harassing in the greatest degree. 

As soon as the plague began to subside, Sir Thomas quitted Corfu, 
being called to Malta by public business ; but he left a most active and able 
officer at Corfu, Major-General (now Sir Charles) Phillips, who fulfilled the 
duty delegated to him by Sir Thomas most completely. 

I am sure Sir Charles would not withhold his testimony of your valuable 
services in the plague of Corfu, which would have more weight than mine. 

I remain, dear sir, yours very truly, 

(Signed) Fred. Hankey. 

Dr. A. White, 
Deputy Inspector of Hospitals, London. 



X 



PREFACE. 



(Letter III.) 

Letter from Major- General Phillips, on the issue of the Proclamation for Free 
Pratique betwixt the District of Lefchimo and the rest of the Island of 
Corfu. 

Corfu, 26th July, 1816. 

Sir, — It is with infinite pleasure I enclose the Proclamation announcing 
the general pratique given to the district of Lefchimo with the whole of 
the Island of Corfu. 

You will perceive that the unlimited and free intercourse commences to- 
morrow, the 27th instant. 

You will distribute the enclosed copies of the Proclamation, and announce 
this most joyful news to all concerned. 

I most heartily congratulate you on having realized this happy period, 
and of having terminated your tedious and most fatiguing duties with so 
much credit to yourself, and with such serious and important advantages to 
the community at large of these islands. 

I remain, Sir, 

Your most obedient servant, 
(Signed) C. Phillips, Major- General. 

P.S. You will report to Lieut. -Colonel Jordan, Deputy - Adjutant - 
General, to-morrow, and you will arrange with him any duties you may 
have to perform, as well as the time you can give up the charge you have 
been entrusted with in the district of Lefchimo. 

Boats will be sent down this evening to bring up and to tow the several 
persons in quarantine. Be very careful that they are not mixed, as they are 
to be kept exactly according to their respective dates in the Lazaretto for 
some days.* 

To A. White, Esq., &c. &c. &c, 
Superintending the plague district of Lefchimo. 



* Note by the Author. — As those persons consisted of a corps of expur- 
gators from Malta, some soldiers belonging to foreign regiments in our ser- 
vice about to be disbanded, felons who had been employed in various plague 
duties, and others, it was not considered expedient that they should be let 
loose at once in the city, until the government had decided, and arrangements 
were made, as to their final disposal. 



PREFACE. 



:\i 



(Letter IV.) 

Copy of a Letter of Thanks from the President of the Senate of Corfu to Staff- 
Surgeon Andrew White, for his services in the Plague of Lefchimo. 

Corfu, 13th February, 1817. 
Sir, — The Senate of Corfu having learned your departure from this place, 
requests you will be so kind as to accept the testimony of its most sincere 
regret for your going away, and its satisfaction for the zeal and attachment 
which you have always showed in your public functions, as superintendent 
of the district of Lefchimo, named to this important charge by his Excellency 
the Lord High Commissioner, Sir Thomas Maitland, during the plague in that 
district. 

In rendering justice to your merit, I declare to you that your services 
have been of the greatest utility, as well for the relief of the human suffering 
kind, as for the absolute extirpation of the dreadful plague which afflicted this 
island during six months : adding to your glory, and that of the officers under 
your orders, that the measures transmitted to you by his Excellency had, in 
their execution, the most sudden and happy success, which was to be expected 
only from your prudence and your indefatigable activity. 

I have the honour to express to you the sentiments of my high esteem 
and consideration. 

The President of the Senate of Corfu, 

(Signed) B. Theotoky. 

Mr. White, Staff Surgeon, &c. &c. &c. 
Corfu. 

(Letter V.) 

Copy of a Letter from the President of the Senate of Corfu to Dr. White, 
for his service in the Plague, and thanking him also for his having settled 
the compensation accounts for the loss of property during the Plague. 

Corfu, a 7 Decembre, 1816. 
Monsieur le Docteur, — J'ai re^u la lettre que vous m'avez fait l'honneur 
de m'ecrire, datee du 3 de ce moi, avec toutes les pieces que vous avez bien 
voulu me faire parvenir. 

Le Senat vous exprime les sentimens les plus distinguees de sa reconnais- 
sance pour la solicitude que vous avez mise a, repondre aux soins dont il vous 
a prie de vous charger. 

Votre exactitude dans les exercises de cette derniere commission* est egalu 
a l'utilite qui a resulte au Canton de Lefchimo a la faveur de vos zeles services. 

Agreez, je vous prie, Monsieur le Docteur, les sinceres assurances de l'estime 
et du respect avec laquelle j'ai l'honneur d'etre, 
Monsieur le Docteur, 

Votre tres humble et tres obeissant serviteur, 
(Signed) B. Theotoky, 

President du Senat de Corfu. 

A Monsieur Monsieur le Docteur White, 
Chirurgien de l'Etat Major, &c. &c. &c, a Corfu. 



* Settling the plague compensation accounts. — A. W. 



xii 



PREFACE. 



Any one must see, on reading Mr. Tully's work, that he 
wishes it to be understood that he had been the only medium of 
correspondence with the government of Corfu, from first to last ; 
and, in order to fix this persuasion on the minds of his readers, 
he quotes, in his note, page 122, a portion of a letter from 
General Phillips (the only one), and that, too, but of a demi- 
official nature, which he received during the whole time he 
remained in the district after my arrival there. This letter was 
on a particular subject immediately concerning himself; audi 
think was enclosed in my dispatches, and transmitted by me to 
him. As it concerned only himself, in order to save time, he was 
ordered by me to reply to it to the General directly, which he 
accordingly did. 

But, in order to prove that I was not in the position which 
Mr. Tully, from his silence respecting me, would lead one to 
believe, I may mention, that I received from the General up- 
wards of 130 public and private dispatches, all, with one excep- 
tion, written by his own hand, dming the time I was in the 
plague district, and all of which I have now in my possession ; and 
that during the same period, my letters to him alone, of which I 
have kept copies, all in my own hand- writing, amount to 129, 
independent of almost daily orders and instructions, which I 
had to send throughout the district ; and of my having to 
attend to all reports which required immediate notice. Even 
all this was but a small part of the duties I had to perform ; for 
I was obliged to have a watchful eye on the whole of the exe- 
cutive ; to attend to the health of the troops, and the wants of 
the inhabitants ; to make my tours of inspection ; to overlook 
the expurgation ; and ascertain, from ocular demonstration, 
everything that was going on, in order to form my reports 
against a certain hour, for the information of the government ; 
to examine in person every house, hole, and corner where the 
plague had appeared throughout the whole of the upper district, 

with the exception of the village of Critica ; and various other 

duties, which it were needless to detail. 



PREFACE. 



xiii 



It is true, that after Mr. Tully was detached to the lower 
district, it became unnecessary for me to go down there so often 
as I should otherwise have been obliged to do. But still, his 
reports to me, and the state of the camps, rendered it incum- 
bent upon me to go thither frequently, and almost daily, to 
inspect, at least, the camps. I may add, that Mr. Tully, in 
looking after the lower district, had nothing else to do but to 
transmit the report of the proceedings to me. 

I am led to make this last remark, from several passages in 
his book, particularly that in page 154. " Having," says he, 
" upon the extinction of the plague in Corfu, performed, in 
common with the inhabitants of Lefchimo, forty days of foul 
quarantine ; and after several days of our clean quarantine had 
elapsed, I was visiting the troops composing the principal 
cordon, when I was met by Major- General Sir Charles 
Phillips," &c. 

Now, the fact is, Mr. Tully had nothing whatever to do with the 
cordon, which was regularly inspected by myself once or twice 
a week, according as I deemed it necessary, or as my reports 
from thence demanded. It is, however, of little consequence 
whether he or I inspected that post ; nor, indeed, should I have 
ever noticed the circumstance, were it not that he everywhere 
wishes to make it appear that he alone had been doing every- 
thing, while I remained quite useless, though his immediate 
superior, and carefully looking after everything without reference 
to him. 

I am really sorry that Mr. Tully, whom I otherwise esteem, 
and who, I am sure, had never any reason to be dissatisfied 
with my conduct towards him, should have so committed him- 
self in the opinion of all those acquainted with the subject, by 
making so unmerited and insidious, or, to say the least of it, 
such a negative attack upon me ; which, however, I ascribe not 
to any personal ill-will I bore towards him, — for that I should 
think impossible, — but to that love of fame which, in its eager- 
ness to snatch its object, stoops not to consider the means of 



xiv 



PREFACE. 



fairly securing it. His conduct, however, in this respect, is to me 
the more surprising, as he must have been aware that there is 
more than one pretender to fame and laurels for services in the 
plague of Lefchimo, who, notwithstanding, in point of fact, had 
little or nothing to do with it.* 

It may here be proper to observe, that one cannot be too 
careful and circumspect in entering on correspondence rela- 
tive to the plague during the prevalence of the calamity. 
General Phillips was so sensible of the impropriety of keeping 
up any such gossiping correspondence at Malta, through fear 
that misrepresentations of any occurrences that took place 
should go abroad, so as to interrupt the public tranquillity, by 
exciting unnecessary or false alarms upon the subject, or perhaps 
affect our commerce over the whole of the Mediterranean, that 
one of the particular injunctions I received from him on my 
taking charge of the district, was to avoid all such corre- 
spondence, and to confine my reports of all occurrences to him- 
self alone. It was chiefly, or rather, I may say, entirely a com- 
pliance with this order which prevented me from communicating 
so freely with the medical board in London and the senior 
medical officer in Corfu as I otherwise should have considered 
it my duty to have done. But it would also have been quite 
impossible for me to have sent duplicates and triplicates of my 
daily dispatches to the General and to other quarters at the same 
time. Even if I had not been prohibited by the cause I have 
mentioned above, I had not time to do so, as I had no clerk on. 
whom I could sufficiently depend for assistance. Every dis- 
patch to government, and every order I gave, was written and 
recorded by my own hand ; and it was as much as I could do 
to get them ready against the time they were called for, as 
every one in the city was anxious for the reports from Lefchimo, 

* I allude here to a gentleman who held a temporary appointment in the 
Health Office at Corfu, but who never even entered the plague district until 
all quarantine restrictions were removed. He, too, absurdly called upon me 
to malce special reports to him, although I was much his senior, and altogether 
very differently situated. 



PREFACE. 



XV 



to know what was going on there at that momentous period. 
This I once and again represented to my superior officer, Deputy- 
Inspector Portious, adding, that the plan of operations going 
on was separation, segregation, and subsequent purification, and 
that General Phillips would always show him my reports. I 
therefore beg to offer this as an apology to the Army Medical 
Board and the senior medical officer then in Corfu, for my 
apparent neglect of duty, as well as to point out and explain 
the peculiarity of my situation. Indeed, I was under the 
necessity of sending the few letters which I wrote home from 
Lefchimo — all, except my official dispatches — open, for the pur- 
pose of fumigation, and of course they were thus liable to be 
read by those who had nothing whatever to do with their con- 
tents. 

It is necessary I should mention that the account given of 
the march of the plague in Chap. VII. of Part II. does not 
apply to what has actually happened in any one particular 
plague ; for no two plagues were ever precisely alike, either in 
their extension, or in the means adopted for their suppression. 
That article is framed from occurrences which happened in the 
plagues of Moscow, Malta, Corfu, and other places, and is here 
detailed to show how plague extends itself, and to point out 
the difficulties which frequently start up at the commencement 
of the calamity, which it is proper to be aware of, and as much 
as possible to guard against. 

In a work of so homogeneous a nature as this is, it is almost 
impossible to avoid all repetition ; I have, however, endeavoured 
to do so to the utmost of my power. 

The plan of operations adopted for the suppression and ex- 
tinction of the plague in Lefchimo may not be precisely the 
same which other plagues may require, although the general 
principles which I have detailed must always be the same, wher- 
ever plague appears. Partial deviation from it may be neces- 
sary, from local causes, moral character, and other circum- 
stances, which it were needless here to enlarge upon. 



xvi 



PREFACE. 



It is pleasing, withal, to reflect, that a calamity so dreadful in 
its consequences, and so extensive in its ravages, may, by 
proper management, not only be kept within bounds, but even 
be forcibly extinguished, under the most aggravated circum- 
stances ; and it would now be discreditable to allow it to extend 
itself, as it has formerly done, when measures of restraint were 
not so thoroughly understood as they now are. 

Should what I have here thrown together on the subject tend 
in any degree to prevent or lessen the sufferings of my fellow- 
creatures from this most awful of known diseases, I shall 
account my object gained, and my labour fully compensated. 



INTRODUCTORY [DISCOURSE. 



At a time when the doctrine of the contagion of plague has 
in a high degree attracted the attention of her Majesty's govern- 
ment, and when an opinion respecting its nature and qualities, 
which I presume to term erroneous, seems to have considerable 
weight, and might, if adopted and acted upon, lead to incal- 
culable distress, and affect, in a way to be deprecated, our 
political situation, I think it the duty of every one who has seen 
this terrible disease, and paid attention to it, to give publicity 
to his experience on the subject. It is indeed the duty of every 
member of the medical profession to communicate to society 
whatever discoveries, improvements, and useful observations he 
has been able to make in all the branches of his science ; but 
more particularly on a subject of such vital importance to man- 
kind as the plague. 

Such are the motives by which I am actuated in laying 
before the public the following pages ; and in venturing to differ 
in opinion from some eminent and enlightened individuals, I 
beg to be understood, that I only do so from the fullest con- 
viction in my own mind of the truth of the doctrine which I 
advocate, and of the danger to be apprehended from the adop- 
tion of contrary opinions on the subject. 

I am far from pretending to have made any discoveries in the 
plague, or any new improvements in its medical treatment ; but T 
am so thoroughly convinced of the advantages which resulted from 
the plan of management adopted during the term of the duration 



•2 



INTRODUCTORY DISCOURSE. 



of the plague in the island of Corfu in 1816, when the infected 
district of Lefchimo was placed under my superintendence, that 
I think I should be deficient in my duty were I not to give it 
publicity:* and, without arrogating anything to myself, or the 
military and medical officers employed on that occasion, I may 
be permitted to say, that few plagues were attended with more 
aggravated circumstances (although the mortality was not very 
considerable from the time I was nominated to the charge), or 
more happy in the results, than the one in the district of 
Lefchimo : and in the treatment of it an example is given, and 
a striking proof afforded, of the benefit accruing from a well- 
regulated and vigorous police ; which, I trust, will be again 
adopted should ever that dreadful scourge hereafter make its 
appearance amongst us, or break out again in any of our 
colonies. 

I am of opinion that the plague is a highly contagious dis- 
ease ; and I ground this opinion not only on what I conceive to 
be respectable authority both ancient and modern, but also on 
my own experience, and undoubted facts.f 

The plague being a disease which has appeared in most 
countries, at some time or other, which has lately shown itself 
in more than one of our islands in the Mediterranean, adjoining 
the Turkish dominions, and which may again, as it has formerly 
done, find its way into Britain, the consideration of this impor- 
tant subject at the present moment may not be altogether with- 
out its use, notwithstanding that much has already been -written 



* It is unnecessary here to mention the reasons which prevented this work 
from appearing before. 

j During the time I was serving in the Mediterranean, from 1811 to 1817, 
the plague broke out in Calabria, Malta, Corfu, and Cephalonia ; and it was 
not doubted that it was imported by means of some evasion of the laws of 
health. I take no notice of the Turkish dominions and Egypt, where it frequently 
exists, with more or less fatality. No general plague has occurred in any of 
our possessions there since that of Corfu. I have heard that individual eases 
have appeared in the Lazarettos since that time, which, however, were promptly 
suppressed, as they always can be, by proper management. 



INTRODUCTORY DISCOURSE. 



3 



on it; and I think it the more necessary to enter on this matter, 
and give my ideas concerning it, as some doubts seem still to 
be entertained whether, under any circumstances, this awful 
malady could be imported into Great Britain, or propagated in 
our climate ; some denying that the true Levant plague ever 
existed, or could exist, in this country (vide the Parliamentary 
Report, pp. 72 — 74) ; and others proclaiming in loud terms, 
not only the inutility of the quarantine laws, but the great 
cruelty and monstrous absurdity of all such restrictions. When, 
therefore, such dangerous opinions as these are attempted to be 
promulgated, I think it necessary that something should be 
done by way of counteracting them, and of guarding society 
against adopting such doctrine, as it is very easy to foresee the 
dreadful effects they might have, and the direful consequences 
that would result from an abolition of the quarantine laws, were 
such sentiments to gain the ascendancy, and obtain the credence 
of the executive government. 

With regard to the first assertion — namely, that the true 
Levant plague was never in England — I believe there are very 
few who have read the history of the plague which overwhelmed 
London in 1665-66, and who have seen those of more modern 
times, who will attempt to question their identity : and, with 
regard to the latter, if it can be proved to be an imported dis- 
ease, and propagated both by persons and goods, — which I think 
I shall be able to prove, — it follows, I should think, as a matter 
of course, that every possible precaution ought to be taken, both 
to prevent its introduction and its extension, if unfortunately it 
should happen to invade any part of our dominions. 

It fell to my lot to serve on the duty of the plague in Egypt 
in 1802, when I was attached to the Indian army. The disease 
had attacked that army in 1801, when it was encamped at El 
Hamet, on the banks of the Nile. On the breaking out of the 
disease, the assistant-surgeons and hospital mates doing duty 
with that army were called together, and it was determined 
that lots should be drawn by them, and that each officer should 



4 



INTRODUCTORY DISCOURSE. 



serve in his turn according to the number he drew. I was not 
called upon in this particular service till the February fol- 
lowing, when it was reported at head-quarters by Major 
Falconer, the then commissary-general of the Indian army, that 
the plague had made its appearance in his department, which 
was stationed at Rachmanie, on the Nile. 

Before the army was moved down from El Hamet to garrison 
Alexandria, the disease had got into the second battalion of the 
seventh regiment of Native Infantry, and many were falling 
victims to it, so that it was not considered prudent to remove 
that battalion with the rest of the army. 

I was at this time in charge of the medical stores of the army, 
which I was to bring down to Alexandria ; but being encamped 
close to the regiment, and in the constant habit of seeing the 
men, I had an opportunity of noticing the disease which was 
making such havoc among them, although I had no immediate 
charge of them; and I then saw three, four, and sometimes five 
of the men carried to the pest-hospital in a day. Nor did it 
unfrequently happen, that some of them were found to be dead 
before they reached the hospital, although their distance from 
it was scarcely half a mile. The men were always sent to the 
hospital the moment the decided symptoms of plague appeared : 
yet they were unable on some occasions to bear the trifling 
movement to which they were subjected in their removal thither. 
I confess, I was much surprised at the astonishing rapidity 
with which this destructive enemy of the human race carried off 
its victims. 

About this time, a Doctor Whyte, who, I understood, had 
come to the Levant as a volunteer physician in the suite of the 
Earl of Elgin, then our ambassador at the Porte, wished to be 
employed in the pest-hospitals of the army, and to make expe- 
riments on the disease, which he considered to be neither con- 
tagious, nor attended with danger, but dependent on pletlw?*a, 
particularly of the vessels of the head. After some time, his 
services were accepted by General Baird, and he was allowed 



INTRODUCTORY DISCOURSE. 



5 



to do duty in the pest-hospital at El Hamet, He, however, had 
not been long in it when he was attacked by the disease, and 
he fell a sacrifice to his own rashness, in the pest-house at 
Rosetta, after his removal from El Hamet. 

The disease was at this time in the city of Alexandria, but 
not in such a violent degree as to excite much sensation among 
the inhabitants, who are so often accustomed to its visitations. 
It occurred occasionally among our troops also ; however, by 
prompt measures in removing the sick to the hospital, and 
placing those to whom communication with the impested could 
be traced, under quarantine restraint, while the troops among 
whom it had appeared frequently changed quarters, the disease 
was pretty well kept under. 

The report from the commissary-general having arrived at 
head-quarters, stating that the disease had got among the 
Indians attached to his department, who were employed in 
collecting the supplies for the army, that some had already died 
of it, and that others appeared to be very ill, I was immediately 
ordered by Sir James McGregor, then the superintending sur - 
geon of the Indian army, to proceed to Rachmanie on that 
duty. An escort of the 26th Dragoons was ordered to accom- 
pany me, to protect me from the Bedouin Arabs, who were 
sometimes very troublesome to travellers on the road ; and, in 
less than two hours from the time I received my orders, I 
quitted Alexandria for this service. I reached Birket, the 
first military post, that night. The next morning at day- 
break, as soon as my escort was ready, I proceeded to Daman- 
hour, and from thence to Rachmanie, which I reached that 
evening, when I reported myself to Major Falconer. 

Being fatigued by the journey, which, I think, was between 
seventy and eighty miles, and night coming on, it was impossible 
for me to do anything more than to make inquiry into the cause 
which induced the Major to make his report. He told me that, 
as no fresh case had occurred since he had sent the sick 
away, he was in great hopes that it was only a false alarm, and 

c 



6 



INTRODUCTORY DISCOURSE. 



that he thought the disease was not plague, but a bad cold, 
with which the men had been attacked : that all the persons 
immediately about him appeared to be in perfect health ; but 
that, in the first instance, as a measure of precaution, he had 
separated those who seemed to him not to be well from the 
rest, and had removed them and the persons living in the same 
tents with them, to a small island in the Nile, opposite to his 
encampment ; that he had, a short time before, been down there 
to make inquiry how they were going on, and that the answer 
he had received was, that they were all doing very well. 

As I was very anxious to know the real state of matters, the 
next morning, after taking an early breakfast, I myself proposed 
to go over to see them, in order to satisfy my mind whether the 
disease was the plague or not ; for I could not feel satisfied till 
that point was fully ascertained. I assured the Major that for the 
present I would avoid any intercourse with the sick, as I should 
be again obliged to return to him before I was prepared to com- 
mence my duty, should the disease prove to be the plague. To this 
he readily assented, and furnished me with a boat for that purpose. 

On my examining them, I soon discovered that the report 
was no false alarm, but that it was the true plague which 
had got amongst them : that two of them were actually dying ; 
and that three Lascars and one woman were very ill with buboes 
in their arm-pits and groins. 

The number of persons thus separated and sent over to this 
island when I went to examine them was, I think, nineteen in 
all, — viz., seventeen men and two women, of whom, as I have 
already said, two were in articulo mortis, and three men and one 
woman were very ill, with violent symptoms of the disease; 
they, in fact, died in a few days afterwards. The rest seemed 
to be in health. 

Having ascertained beyond all manner of doubt that the 
disease was the plague, and given some necessary directions to 
the people, I returned to make my report of the state of matters, 
and to make some private arrangements preparatory to my per- 



INTRODUCTORY DISCOURSE. 



7 



manent residence in the island, which I intended should com- 
mence the next morning. 

On making inquiry as to the state of the health of the town 
of Rachmanie, near to which the commissariat depot was es- 
tablished, I found that the plague had been raging there for 
some time, and that a great many persons were dying of it ; 
that the disease was also in the neighbouring villages ; and 
that it must have been brought to the depot either by the 
Arabs employed in bringing the supplies, or perhaps by some 
of the Indians, who were apt to absent themselves and go prowl- 
ing about the neighbourhood. 

The next morning, early, I commenced my painful duties ; 
and here I may mention, that having been sent off in such a 
hurry, I had literally nothing, but as I stood, neither personal 
baggage, medicines, hospital equipment, nor even a servant to 
attend me, nor hospital servants of any description. 

I have much pleasure, however, in acknowledging the dis- 
interested kindness of Major Falconer at this time. He, see- 
ing my unpleasant situation, most handsomely afforded me 
every assistance in his power, providing me with a tent for my- 
self, some blankets, wine, and also ready-dressed provisions from 
time to time. He also soon after procured me what, in my 
situation, was truly invaluable — an Arab boy, as a servant, who 
had been following the kitchen establishment of General Menou, 
the commander-in-chief of the French army. Fortunately for 
me, this youth understood a little French, and also something 
of cookery. This clever little boy was an inexpressible com- 
fort to me, both as my cook and my interpreter. My patients 
were all Indians, whose language I could neither speak nor 
understand. The only hospital servants I had with me during 
the whole time were two Arabs, who were sent me for the pur- 
pose of burying the dead, to assist in removing the tents, and 
performing other duties ; but from my ignorance of their lan- 
guage, I was at a loss to make myself understood by them. 
My young interpreter, who, I have said, understood a little 

c 2 



8 



INTRODUCTORY DISCOURSE. 



French, brought me out of this dilemma. One of the Indians 
with whom I was now associated spoke the Arabic pretty well ; 
indeed, many of them seemed to pick up that language with 
considerable facility. When I had any directions to give, I 
called my boy, and explained to him what I wished to be done. 
He again translated what I had said to the Indian who under- 
stood the Arabic, and this one, in fine, to his companions ; so 
that, after making this round, I felt, comparatively speaking, 
quite comfortable and happy, in being able to explain what 
was necessary to be accomplished. 

When I had gone over to my island, which was formed by 
the Nile dividing itself into two branches, I was furnished with 
a speaking-trumpet, for the purpose of making my communica- 
tions with Major Falconer ; because that branch of the river 
which intervened between him and me was so broad, that my 
voice could not be heard at the opposite side, even when the 
wind was not contrary. I thus began my labours, cut of! from 
all society, except that of the Indians and Arabs mentioned ; 
surrounded by patients actually ill of the plague, some of whom 
were dying, and by those who, though they seemed at the 
moment to be in health, I knew, from the promiscuous inter- 
course which had taken place between them and the others, 
might every moment be expected to fall sick ; at the same time 
that the calamity was making cruel havoc among the neigh- 
bouring villages ; without any friend to assist me, should I 
myself happen to fall sick, or to relieve that depression of 
spirits and anxiety which, notwithstanding all our endeavours 
to prevent it, will occasionally affect us. 

My first step after my arrival on the spot was to make a minute 
inspection of the whole, and to separate those who were in any 
way indisposed from the rest. The persons labouring under 
positive symptoms of plague I placed in one tent, and those 
whose cases seemed to me to be doubtful at the moment, in 
another, with orders that no intercourse whatever should take 
place between them. The sick-tent I caused to be pitched at 



INTRODUCTORY DISCOURSE. 



9 



some short distance from my own. The persons who, to all 
appearance, were in health, I placed in tents close to my own, 
that they might be more immediately under my inspection, so 
that I might have a better opportunity of attending to the rigid 
performance of their quarantine, and of examining their state 
of health from time to time, to enable me to lay hold of the 
disease the moment it made its appearance. I explained to 
them all, in the best manner I could, my reasons for making 
this separation, and the absolute necessity that there was on 
their part to act in conformity with my orders for the speedy 
destruction of the malady. I recommended to them, in the 
strongest manner I was able, not only that they should have 
no communication either directly or indirectly with the sick or 
suspected tents, over which I placed part of those who appeared 
to be in health as a guard, but I directed, also, that none of 
the tents should have intercourse one with another. I ex- 
plained to them the dreadful consequences that would follow if 
these orders were not strictly obeyed, in which case, most pro- 
bably, one and all of them would suffer. 

Whatever might have been the religious prejudices of these 
Indians, I have no reason to doubt that my instructions were 
attended to. Their obedience to military authority, and the 
deference and respect they generally pay to the commands of 
an Euroj>ean officer, were quite sufficient to prevent them from 
disobeying these injunctions ; and I do not doubt but that 
they were most strictly complied with. 

Whilst I was occupied with these arrangements, two of my 
patients in the hospital-tent had died, one or two others were 
in a dying state, and some of the others were decidedly worse. 
The supply of medicines, having been sent up in one of the 
commissariat germs, (a kind of boat used on the Nile,) did not 
arrive till several days after my entering upon this duty. I 
had, therefore, no medicines to give the sick ; and even if I 
had had all those which I might have judged to be proper, I 
question much whether any benefit would have been derived 



10 



INTRODUCTORY DISCOURSE. 



from their exhibition, at least, with several cases in the hos- 
pital — with such rapid strides had the malady advanced in its 
destructive career. 

During the period of my residence on this island, I had the 
most convincing proofs that the plague existed, not only in 
Rachmanie, but in several of the neighbouring villages, from 
the dreadful yells of the women, lamenting the loss of their 
husbands and other relatives ; for every morning at daybreak, 
and at intervals during the day, they rent the air with their 
shrill and piercing shrieks. I was unable for some time to 
account for this singular and woeful noise, which, amidst the 
universal silence that otherwise prevailed, used to awaken me 
from my slumbers at such early hours, until, on asking my 
Arab friends, they immediately told me the cause of it. The 
women, it would seem, in those countries, are accustomed to 
deplore in this outrageous manner the loss of their husbands 
and relations ; though, considering the ill-usage these poor 
creatures generally meet with from the men, I could not help 
thinking that their grief, which showed itself so violent on these 
occasions, was more feigned than heartfelt and real. 

It is not my intention here to enter at large into a detailed 
account of the plague which I saw in Egypt, nor into the mode 
of its cure, in which, I regret to say, I was very unsuccessful ; 
as any remarkable circumstances which came under my obser- 
vation were reported to, and have been already detailed by, 
Sir James McGrigor, in his " Medical Sketches." The prin- 
cipal advantage accruing from my exertions on the occasion 
just mentioned, seemed that of preserving the uninfected from 
contagion, by means of a strictly-enforced adherence to qua- 
rantine : for, as far as I remember, only one man was attacked 
after I had made the separation betwixt the sick and the 
healthy. The cases which I thought doubtful at first, turned 
out afterwards to be confirmed plague, and were sent to the 
hospital, where, I think, all but one died. Those who did not 
take the plague — amounting to nine — joined their department at 



INTRODUCTORY DISCOURSE. 



11 



the expiration of their quarantine, after having undergone the 
necessary purification, and been supplied with fresh clothes. 
They afterwards returned to India, when that army was re- 
called, which happened shortly after they were liberated from 
quarantine. 

Having given this short account of the plague which appeared 
in the commissariat department of the Indian army, it may be 
expected that I should here say something of the plague which 
broke out in the district of Lefchimo, in the Island of Corfu, in 
the year 1815. But as the detailed account of that plague 
forms a considerable part of the following work, I shall reserve 
what I have to say on this subject till I come to its proper 
place, and shall only add, at present, that in the general cha- 
racter, both diseases were the same. The latter was happily 
suppressed under that distinguished officer, Lieut. -Gen. Sir 
Thomas Haitian d, the Lord High Commissioner of the Ionian 
Islands, whose active exertions were so conspicuous in keeping 
under, and finally extinguishing, the plague at Malta, and 
whose enlightened and comprehensive mind displayed itself so 
eminently on that occasion. In the execution of his plan in 
Corfu, his Excellency thought fit to appoint Major-General Sir 
Charles Phillips to the direction of the whole of the plague 
duties, and myself to the charge of the executive within the 
district. The Major-General, from his meritorious services and 
uncommon exertions during the plague at Malta, which hap- 
pened two years before that of Corfu, was peculiarly adapted 
for this important charge. He knew well, from his personal 
experience on that occasion, all the difficulties that arise in the 
arrangement of a duty of this kind. He had thoroughly studied 
the nature and advantages of plague-police in all its ramifica- 
tions. He knew that this most formidable and treacherous 
enemy could be forcibly put down, and finally destroyed, by 
proper management. His instructions, which were sent to me 
regularly from Corfu, by the dragoons employed on this seivice, 
were clear and distinct ; whilst my reports to him gave a faith- 



12 



INTRODUCTORY DISCOURSE. 



fill account of the occurrences of the day ; and the machinery 
(if 1 may be allowed to use the expression) in the plague district 
was regulated with such ability and precision by him — and I will 
also say, conducted with such zeal and activity by the different 
officers employed — that I will venture to affirm, without fear of 
contradiction, that, from the time it was vigorously put in exe- 
cution, no plague was more speedily crushed, or more satis- 
factorily extinguished, than that of Lefchimo. 

My own duties, as superintendent of the plague district, con- 
sisted in the immediate charge of the execution and carrying 
into effect the instructions I received from time to time from 
head-quarters ; and I must candidly confess, that without the 
instructions of the Major- General, it would have been impossible 
for me, at that time, to have directed the various movements 
that it became necessary to make, or to have carried the plan 
of management into operation ; for it is only by experience 
that a duty of this kind can be understood and regulated, since 
even the greatest zeal and most unremitting activity will some- 
times do harm instead of good, unless they are properly 
directed. 

It is true, that the plan of operations which was here adopted 
was not carried into full effect until after the violent ebullition 
of the disease was over, and consequently, till after the principal 
mortality had taken place, which was before we arrived ; but 
the certain efficacy of that plan appeared from the manner in 
which the evil was so promptly suppressed from time to time 
whenever it started up in this extensive district, as well as 
from the complete extinction of the malady after the plan of 
operations had had time to have due effect, or, as I may say, 
were finally brought to a close ; nor did any circumstance ever 
occur afterwards which in the smallest degree led to any sup- 
position that this dreadful malady was not entirely annihilated 
— a happy event, which has seldom occurred in other plagues, 
and which can be attributed only to the system so fully carried 
into effect, We well know what dreadful anxiety prevails for 



INTRODUCTORY DISCOURSE. 



13 



a long time after the supposed extinction of the plague, and 
what unspeakable distress the recurrence of one solitary plague- 
case will cause at that time, as throwing a doubt on all the 
arrangements adopted. On this occasion, however, nothing 
of the kind happened ; and from the day that pratique betwixt 
Lefchimo and the rest of the island was proclaimed, till the 
present hour, the public health — at least, from plague — has 
been perfectly secured. 

It is in the beginning of plague, as soon as ever the disease 
is positively known to exist, that everything is to be done to 
put an immediate stop to it by the application of the proper 
remedies ; and if it is confined to a particular spot, as often 
happens, it may easily be suppressed by proper management, 
as has lately been done in Cephalonia, and is not unfrequently 
done in lazarettos. But when it has been allowed to extend 
itself over the face of a country, it then becomes a most difficult 
task indeed, as well as a most expensive one — requiring con- 
siderable length of time and immense labour to all concerned 
in this duty. Had the plan of management which was sub- 
sequently carried into vigorous effect under the directions of 
Major- General Phillips and myself been fully acted on at the 
beginning, in Corfu, when the disease broke out there, I have 
not the least doubt but it would have been speedily suppressed. 
But, as usually happens on occasions of this kind, much valu- 
able time is lost before the disease is pronounced to be plague. 
A variety of opinions are given on the nature of the prevalent 
disease, as every one is unwilling to pronounce the dreadful 
word plague whilst a doubt remains on his mind upon the sub- 
ject — a report which, if true, is fraught with such awfully im- 
portant consequences, that one becomes appalled at the very 
thought of them. 

I shall endeavour, in the course of the following work, to 
give such an account of the characteristic symptoms of this 
disease, as, coupled with other collateral circumstances, will, 
I hope, tend to remove that obscurity which hangs over it, 



14 



INTRODUCTORY DISCOURSE. 



and enable us to decide at the beginning (when it is a matter 
of such high importance) what the plague is, in order that as 
little time as possible may be lost in the commencement, when 
every moment is of such incalculable value, if the proper re- 
medies are applied to suppress it. 

I shall also give a short history of the plague both in ancient 
and modern times ; and endeavour to make it appear that the 
plague is a disease sui generis, depending on specific contagion, 
and unaltered in its character from the first records which we 
have of it till the present day ; a disease little controllable by 
medicine, but perfectly obedient to the laws of separation and 
segregation, absolute non-communication, and purification ; and 
so long as we are able to keep ourselves from actual contact 
with the impested, or with things impregnated with the virus, 
there is not that cause for dread and alarm which has generally 
been supposed.* 

* It is true, that in the plague in Egypt, I myself was obliged, from 
circumstances, to be in communication with my patients, and escaped ; but 
several other medical officers fell victims to it there, whilst others caught the 
disease, and narrowly escaped with their lives ; and I confess that at that time 
I did not understand the principle now advocated, of avoiding contact with 
plague patients, nor did I act upon it. Nor, indeed, was it fully known to 
the medical officers of that army ; although every one had, more or less, a 
dread of the plague. 

It was during the plague at Malta that this principle became better under- 
stood and acted upon ; and there its humane and salutary effects were most 
obvious and unexampled in suppressing- this calamity. 

Every one but sceptics have considered the plague-service a very dangerous 
one ; and Sir Thomas Maitland, in asking me to take the charge in Lefchimo, 
was so fully aware of this, that, I being a family man, he kindly gave me two 
days to consider of it. I only took one ; reported myself ready for that service 
next morning, and went down to take charge that same evening, remaining 
there until free pratique was issued by proclamation, and the plague was 
happily extinguished. 

I have said, that when I undertook this duty, I did not fully comprehend 
the nature and value of this system of operation ; and I can well remember, 
that for a long time after I went down to the impested district, I passed many 
a sleepless night after my harassing and anxious duties during the day, be- 
lieving that I had got the plague. I rose next morning with the same horrid 
feelings, to perform my various duties. I found it no easy matter, for a con- 
siderable length of time, to divest myself of these feelings. 



INTRODUCTORY DISCOURSE. 



15 



It would have been satisfactory to me, in treating of the 
plague in Corfu, if, when I was nominated by Sir Thomas 
Maitland to the charge of the plague-district, I had been fur- 
nished with official documents respecting its rise and progress, 
and other information, which it was proper for me to have been 
made acquainted with. I had, however, no written document 
of any kind given me, except the daily sick-returns, from the 
7th of March, just three weeks previous to my arrival in the 
district, and the correctness of which I had no means of ascer- 
taining. 

I called for written documents of the march of the dis- 
ease, in order to know in what state things were, both in the 
upper and the lower part of the district, where, according 
to verbal accounts, the disease was still lurking, but I was 
told there was none. In consequence of this want of informa- 
tion, I was obliged, after a painful and anxious inquiry, to gain 
my information from every source where I thought I was likely 
to obtain any, particularly from the medical officers stationed 
in the villages ; and who, having been resident in them for 
some time previous to my arrival, and having made it their 
business to inquire into the history and progress of the disease 
within their respective stations, were perfectly competent to 
afford me the information I sought for. But I had the sa- 
tisfaction of having their testimony corroborated by colla- 
teral information from among the most intelligent and better 
informed of the inhabitants themselves, in whose memory the 
recent occurrences were still fresh. I do not doubt, therefore, 
that the account which I shall give in the narration is strictly 
correct, and may be depended upon. 

I know it is a very difficult matter during an attack of plague 
to get at the real truth of many circumstances which occur. 
People are often very reluctant to tell what they know, partly 
from motives of mistaken friendship, and partly for fear lest 
they themselves should be implicated, or brought into trouble 
by boldly coming forward to give what information they pos- 



16 



INTRODUCTORY DISCOURSE. 



sess on the subject. Besides, it not unfrequently happens, that 
malevolence and an old grudge will induce wicked persons to 
state things very differently from what they really are ; and this 
is sometimes so much the case, that I had almost said, that we 
can only depend on what we actually see with our own eyes. 
In searching for information relative to plague matters during 
the time of its existence, we ought to make ourselves ac- 
quainted as much as possible with the moral character of the 
person or persons from whom we expect it. We ought to 
ascertain that their motives in giving it are pure, and that they 
are not biassed by party feelings or private considerations, or 
we shall assuredly be deceived, and induced to do what is 
wrong, and what may ultimately lead to very distressing con- 
sequences. 

It is an established maxim in the police treatment of plague, 
that half measures will never exterminate this dreadful enemy. 
The snake may be scotched, but not killed. The road is 
straight-forward, and we must not deviate from it. Whenever 
positive disease exists, it must be instantly removed to its proper 
place, and this without regard to condition, sex, or age ; whilst 
those in immediate intercourse with the sick, and who, in the 
eye of the strict laws of quarantine, must be supposed to be 
impested, are also to be removed and placed under proper 
quarantine restraint, until their system is satisfactorily ascer- 
tained to be free from contagious taint. It may happen, un- 
doubtedly, that eventually all will escape, and none of them 
take the plague. Happy, indeed, where it occurs, should this 
turn out to be the case. But as this cannot be known a priori, 
notwithstanding that they may appear to be in perfect health at 
the time, we are bound, by every principle of sound policy and 
humanity, not to permit those in health to remain with the sick 
for one moment after the existence of positive plague is ascer- 
tained. Every instant that they continue in communication 
with the indisposed adds to their immediate danger, and to the 
risk they run of becoming attacked by the disease. 



INTRODUCTORY DISCOURSE. 



17 



I have said that it is possible, and there are, no doubt, in 
plague records many instances, that the plague may get into a 
family without attacking more than one person ; but most 
assuredly this is not to be calculated upon or looked for. I will 
venture to say, that in fifteen cases out of twenty, and I be- 
lieve I may even say in a still larger proportion, the contrary 
will happen, if nothing is done to counteract the progress of the 
disease ; for, when once introduced into a family, no matter 
by what means, it will sometimes run through that family, 
ceasing perhaps only with its total extinction, leaving but one 
or two individuals to mourn over the entombed relatives who 
have been thus suddenly swept away from them. With regard 
to this, however, no calculation can be made, when once the 
disease has been introduced ; and it is quite impossible to say 
who are to be the victims, and who are to escape. The sooner, 
however, that the separation takes place, the greater is the 
chance of escape to those who appear to be in health. 

I am here supposing that the plague has occurred in a family, 
some of whom are labouring under the disease, whilst the rest 
are to all appearance in perfect health. I have supposed that 
the sick have been promptly removed to the place assigned for 
their reception, and the rest of the family placed in strict qua- 
rantine. But this is not enough. We must go further. We 
must gain information of the persons with whom the family 
have had intercourse, not only since they fell sick, but also 
some short time before ; and they also must be separated from 
the community, and placed under observation, until their free- 
dom from plague be ascertained, which time alone can prove. 

There are three grades which, in time of plague, are to 
be separated and removed from the community — 

1st. Those actually labouring under positive disease. 

2nd. Those of the same family, who one and all must be 
regarded with suspicion, as more liable to be attacked, from 
their habits of intimacy and actual intercourse with the sick ; 



18 



INTRODUCTORY DISCOURSE. 



and it is here that the disease almost always exists. This I 
denominate the class of high suspicion. 

3rd. The last class or grade are those who have had, or 
are supposed to have had, actual communication with the 
impested family. This naturally forms the most numerous 
class, although the least suspicious one, and consequently the 
most free from disease. This I denominate the class of obser- 
vation, or those simply suspected.* 

In the segregation of this last grade it behoves us to be 
extremely particular to find out all the persons who have lately 
had immediate intercourse with the plague family ; and it would 
be very desirable if we could always get at the bottom of this 
matter. But this we cannot expect to do ; for, in srjite of all 
our endeavours, they will conceal the names of their friends, for 
fear of giving them trouble, an act of kindness the most mis- 
taken that can possibly be. Nay, they will often from the same 
cause positively deny the fact, when the names of certain per- 
sons are mentioned to them as those with whom they have had 
intercourse subsequent to the appearance, or about the time of 
the disease breaking out in the family. 

One thing may be generally done with safety ; and that is, 
we can find out their relatives who are in the habit of inter- 
course with them, and their near neighbours, and remove them 
to observation, whether or not we have proofs that actual com- 
munication has taken place. Were we always able to come at 

* But should it be afterwards ascertained that any of this class have had 
intercourse with positive plague cases, they are obviously liable to be attacked 
by it ; hence the necessity of separation for a period of fifteen or sixteen days, 
during which time they are to continue daily to handle and expose their sus- 
ceptible effects to the air. If this is sfrictly complied with for that period, 
and they are all well, they may be considered safe ; for if they have had 
the infection in their system or clothes, it has been ascertained that it will show 
itself before that time. Should, however, plague break out among them, 
the case is altered, and must be treated accordingly. In fact, they must be 
treated as highly suspected. 



INTRODUCTORY DISCOURSE. 



19 



the whole truth, it would, of course, suffice to act upon that ; 
but this, as I have said, is not to be looked for. We are 
therefore, in a great degree, left to our own discretion, and 
must act from our own judgment. In this matter I have only 
to say, that whilst the public health demands the removal of 
this class from the community, it would be a very cruel and 
unjustifiable act to subject to this inconvenience those who are 
perfectly free from suspicion : for, though no danger can, or at 
least ought to happen to these, while placed in observation, if 
things are properly conducted, yet the very removal of these 
persons, independent of every other consideration, is extremely 
disagreeable to them, not only on account of the private con- 
cerns of their families, but also that of the alarm it causes 
them, and which is the necessary consequence of even this 
slight degree of suspicion.* 

These three classes, of positively diseased, highly suspicious, 
and simply suspected, or under observation, form the three great 
links of the chain of plague, all of which ought to be separated 
from the general mass of the people, and are also to be kept 
perfectly separate from one another : for if, by accident or 
mismanagement, these classes are mixed together — as, for ex- 
ample, the second with the third, — and positive intercourse 
has taken place between them, the character of those of the 
third class becomes thereby deteriorated, and the original dis- 
tinction is lost ; and they naturally participate in the character 
of the highly suspicious, with which they have unfortunately 
become intermixed. I am here, however, supposing what 
ought not to happen, if proper arrangements are made and 
acted upon : but I am induced to be thus explicit, in order to 
show the absolute necessity of keeping the classes perfectly 

* In the plague of Corfu, I ascertained that several of the wicked Lefchi- 
mists spread reports of the existence of the disease from ill-will, or to cover 
their own delinquencies. In these cases, I placed the reporters themselves under 
quarantine restraint for a time, hy removing them to a camp of observation, as 
a punishment, which had a very good effect. 



20 INTRODUCTORY DISCOURSE. 

separate from one another during the performance of their 
established quarantine, and, indeed, from first to last ; for they 
cannot be mixed together with impunity. Even a solitary 
individual of the third class, if by any chance he has had direct 
communication with the second class, cannot be received again 
into his own proper one, without vitiating its character. He 
must therefore remain where he is, becoming identified with 
that class with which he has so unfortunately communicated ; 
and he thus, of course, becomes more liable to be attacked by 
the disease than he would have been had he not been separated 
from his own proper class. He must also necessarily undergo 
a protracted quarantine, the same as assigned to the class with 
which he has had communication, whether such an occurrence 
takes place from mismanagement in the first instance, or from 
his own violation of the laws of quarantine. If the circum- 
stance is owing to the latter cause, he has the less reason to 
complain of such hardship, as it is only the just punishment of 
his own misconduct. 

I am unwilling to increase the different links of the plague 
chain beyond the three I have mentioned ; yet there are doubt- 
ful cases that sometimes occur, which also merit particular con- 
sideration. On examination it is found that, although the 
person is not well, yet that there are not such positive symp- 
toms of plague as to warrant his being sent to a pest-hospital ; 
arid ordinary complaints must of course be more or less common 
in time of plague. In short, it is found that the case is doubt- 
ful, and may in the end turn out to be plague ; but, at the same 
time, it may not, as the indisposition may be owing to causes 
unconnected with the plague contagion. These are embar- 
rassing cases, which are difficult to be disposed of. They ought 
not to be sent to the hospital, and placed among the plague 
patients. It is not proper, however, that whilst this doubt 
remains, they should be permitted to have free intercourse with 
their neighbours. These cases, I think, ought to be removed to, 
and placed in quarantine of observation, apart from each other, 



INTRODUCTORY DISCOURSE. 



21 



and also from the other classes, as in all probability a few days, 
or perhaps a few hours, will decide the matter one way or the 
other. When the disease is found not to be plague, they 
can be sent back to their homes, or to the quarantine class to 
which they belonged before. If, however, it turns out to be 
plague, such person or persons must be sent to the pest-hos- 
pital, and we have the satisfaction of having done everything 
possible to prevent the disease from spreading. In the mean- 
time, that the person is sent to the hospital, the rest of the 
family, being now in a state of high suspicion, must be trans- 
ferred to the class of that description.* If, indeed, we could be 
certain that no intercourse would take place until the doubt 
were removed, we might let the family remain where it is ; but 
as we can seldom, or scarcely ever depend on our injunctions 
being strictly complied with, the safest way will be to remove 
them at once for observation. 

In plague matters it ought never to be forgotten that hu- 
manity to individuals may be the greatest cruelty to the com- 
munity at large. 

Let me explain myself. Suppose that these doubtful and 
perplexing cases should turn out eventually to be plague ; 
would it not have been cruelty in the extreme to the community 
to have permitted the usual intercourse to have existed, and to 
have allowed them to associate with other families who are free 
from suspicion ? — to have allowed this decidedly contagious 
disease to propagate itself perhaps far and wide, as it will inva- 

* I am here speaking of two different cases: the first, of persons being 
unwell at the medical inspections, which, I take it for granted, are made twice 
a day in the houses ; the other, of persons who may be taken ill in quarantine 
of observation at these inspections. In both cases, a most careful examination 
of the persons is required, for ordinary diseases are not suspended in time 
of plague ; and it is a most distressing thing to allow any one labouring 
under any common complaint to be sent into the plague-hospital. Yet I 
have no doubt that this has been frequently done, from not attending carefully 
to this matter. The necessity, therefore, of a very careful examination and 
great discrimination is most important on every account. 

D 



22 



INTRODUCTORY DISCOURSE. 



riably do if not restrained ? It certainly would. The matter 
admits of no doubt whatever. We know sufficiently the insi- 
dious nature of this disease, and its Proteus-like property of 
assuming such various shapes, as to put us on our guard against 
even the remotest suspicion of it ; and it is only by thus boldly 
laying hold of it on suspicion, that it is effectually to be crushed ; 
for if we confine our operations to the weeding out and re- 
moving the cases of positive plague, as they occur, we shall 
perform but a small part of our task, and leave the seeds of the 
disease behind us at every step. 

From what I have here said, it will not, I trust, be ima- 
gined for a single moment that I wish to extend the suspicion 
beyond what is strictly plague, or to cause unnecessary alaim 
or derangement in families, beyond what the urgency of the 
case requires ; or that I would attempt to bring to a pest-hos- 
pital or to quarantine all those who are not in perfect health, 
or those who are free from suspicion of plague. I have cer- 
tainly no such wish or intention. Every one is well aware 
that persons may be ill, and labouring under many diseases, 
particularly those of a chronic nature, in which there is no 
suspicion whatever of the existence of plague ; and I need 
hardly say, that it would be highly improper, not to say cruel, 
to treat them and their families as if they were impested. 
What I have here advanced is intended principally to guard 
medical gentlemen and health officers against placing too much 
confidence in what the parties concerned may state respecting 
their complaints. One should know that peoj)le will often 
try to deceive and impose upon those charged to inspect their 
state of health; and it is therefore right that the inspectors 
should be fully aware of this, and should trust more to their own 
judgment in forming their opinion of the disease, than to 
what they may hear. Indeed, we know that sometimes per- 
sons labouring under the most decided symptoms of plague 
will deny that they are unwell, and appear much offended at 
the bare supposition of their being ill of that disease ; whilst 



INTRODUCTORY DISCOURSE. 



23 



others will most studiously conceal every circumstance that 
could any way lead us to form such an opinion. 

It may be alleged that there is no occasion to separate those 
doubtful cases until the positive symptoms of plague begin to 
show themselves ; for that it is then time enough to treat the 
family as if it were actually labouring under the calamity. 
This, however, I must deny ; for if we wait till the disease is 
completely established, we lose much valuable time ; and, per- 
haps, in the interval, communication with healthy families 
takes place. For in the plague, as in military tactics, we should 
anticipate the enemy. If, indeed, the family can be cut off 
from all communication with others, then they may be allowed 
to remain where they are, until the matter is cleared up. Yet, 
even in this case, the other members of the same family, though 
to all appearance healthy, will, by thus continuing in free and 
unrestrained intercourse with the person or persons indisposed 
among them, evidently run an additional risk of being so im- 
pested, should the disease turn out to be plague. But this 
separation must not be a feigned and illusory, but a real and 
positive one. Regard to the people at large demands that it 
should be so. Still, even in this supposed case, such per- 
mission might lead to bad consequences ; for it is very obvious, 
that although one house, or even twenty, may be strictly 
guarded, so that the non-intercourse is absolute, yet this can- 
not be done in every instance without leading to incalculable 
expenses, and the employment of an immense number of guar- 
dians ; nor would this mode of acting, in the end, be found, 
to be effectual for the public security, as some persons would 
then for a bribe, or from persuasion, be induced at times to 
swerve from their duty, and permit clandestinely that inter- 
course which they were stationed to prevent, as I have reason 
to believe happened more than once soon after the calamity 
broke out in Lefchimo. 

I do not mean, however, that in every instance we are to act 
strictly up to the rule I have here laid down respecting the 

d 2 



24 



INTRODUCTORY DISCOURSE. 



doubtful cases. Peculiar circumstances and local situation may 
authorize in some degree, at times, a deviation from it. But I 
am fortified in this opinion, that the more closely we act up to 
it, the better; and I hold it to be bad policy in the time of 
plague to act with indecision or partiality. 

It ought to be impressed on the minds of the persons under 
suspicion, whom it is considered necessary to separate from 
the mass of the people at large, and place in observation, that 
no real danger can accrue to them from this separation, although 
I admit that considerable inconveniences may thence frequently 
occur ; and, in fact, if things are properly managed, there is no 
danger, provided they themselves are obedient to the rules of 
quarantine. They may have the plague in then constitution, 
and this cannot be remedied ; but they will not get it in obser- 
vation, if they keep themselves perfectly separated from the 
others. If they unfortunately should have been really im- 
pested before they were placed in observation, it cannot be 
helped. Nothing which we know can prevent its appearing ; 
and it will soon show itself. If, however, they are free from it 
when placed in observation, they ought not to contract it there. 

It is thus that the plague is to be destroyed, root and branch, 
whenever and wherever it makes its appearance. The sick 
must be sent to the hospital as soon as ever the positive symp- 
toms of plague shoiv themselves; their families must perform qua- 
rantine as highly suspected: and those, again, with whom inter- 
course with that family is known, or from probable circum- 
stances, is supposed to have occurred, must be placed in obser- 
vation, forming the class of simply suspected. 

I am here supposing that the disease appears in a town or 
village, and the plan of operations which I have pointed out is 
carried into full effect ; by which means the disease will in a 
short time be transferred from the town or village to the hospital 
and places appointed for the performance of quarantine and 
observation. 



INTRODUCTORY DISCOURSE. 



25 



The same general principles are always to be adopted when- 
ever it makes its appearance in any of these two classes. Thus, 
whenever the disease breaks out in class No. 2, or the highly 
suspected, the unhappy sufferers are to be sent to the hospital 
from time to time. Again, if it starts up in the class of observation, 
No. 3, the patient is to be immediately sent to the hospital ; and 
his family, or the persons with whom he has had communication 
must be sent to the class of highly suspected: for, as positive 
disease has appeared in his class, the individuals who have 
been in contact with him are thereby more likely to contract 
the disease, and it is therefore unfit that such should remain 
any longer among those of the class to which they originally 
belonged, for fear of their spreading the disease among the class 
of simply suspected. 

I would earnestly recommend to the persons, both in high 
suspicion and in observation, to have no intercourse beyond the 
immediate parties who are in the same state of suspicion as 
themselves : and, indeed, could it possibly be effected, it would 
be most desirable that every individual be kept separate and 
altogether apart from the rest during the time. Could this be 
done, the plague would be instantly checked, and entirely 
destroyed after its transfer to the places appointed for its re- 
ception. There would then be nothing left to feed and support 
the disease, which would soon die a natural death. 

There is still an important consideration connected with the 
segregation and separation of families in the time of plague, 
which deserves to be particularly attended to ; and that is, the 
state in which their susceptible property is to be viewed. The 
laws of quarantine direct that every house in which the plague 
has existed be expurgated. This pre-supposes that every 
article of a susceptible nature within the house is impregnated 
with the effluvia of plague, and, consequently, is to be perfectly 
purified. 

It is, no doubt, an assumption to suppose that every article 



26 



INTRODUCTORY DISCOURSE, 



in such a house is positively imbued with the virus, or miasma, 
of plague. Indeed, it is not probable that this is the case. 
That, however, is not a matter of any consequence ; because, 
as there are no means of ascertaining what is positively im- 
pested and what not, we must take care to err on the safe side, 
by considering everything in that house impested which is 
supposed capable of receiving the effluvia of pest. Half mea- 
sures will not do ; and we must pay no attention to the accounts 
which we may receive that such an article is impested, and such 
another, owing to particular circumstances, not so. We must 
go on straightforward, and in expurgating or destroying every- 
thing, remove all possible doubts. 

With regard to the houses and effects of those who are re- 
moved only on suspicion, the case is different ; and the proof 
of their houses being free from the contagion of plague is their 
own state of health. If that is good, and continues so till the 
expiration of the period of their quarantine, then there is no 
reason whatever for supposing that anything in their houses is 
impested ; and, consequently, there is no reason whatever for 
allowing the expurgators to enter them, or in any ways to dis- 
turb or injure their property. 

This, however, supposes that the family are in health, 
and, at the time, free from plague. But we must take another 
view of the subject. Suppose, what may frequently happen, 
that the disease breaks out among them a few days after their 
admittance from their own houses into observation. The 
strongest probability in this case is, that they have brought the 
disease along with them, and that they have been impested 
before their segregation. As this is the only fair conclusion 
that we can come to, we are bound to consider their houses as 
impested, from the circumstance of their having taken the 
plague with them ; and, therefore, in every point of view, their 
houses arc to be treated as impested. 

But it is possible that the plague may have been contracted 
by them whilst in quarantine ; that is, that although they had 



INTRODUCTORY DISCOURSE. 



27 



not the plague when they came to perform their quarantine, 
they may have got it there. This, however, requires some ex- 
planation. We do not know, generally speaking, how long- 
disease may lurk in the system before it shows itself. But in 
plague, this matter is perhaps more satisfactorily known than 
with respect to other distempers. It is, I think, distinctly as- 
certained, that with regard to plague, if it is in the system, it 
will show itself before the expiration of fifteen days. Indeed, 
I doubt whether it will remain occult so long ; and the proba- 
bility is, it will show itself before eight days if it really exists. 
I know that we are told that the miasma of plague may lurk in 
the habit for many days. We have heard sixty and even 
eighty days mentioned. My belief, however, is, that this is not 
the fact ; and that, if the matter came to be minutely inquired 
into, we should find that there was a more recent date of con- 
tact with impested persons or things, to which the malady is to 
be attributed. 

If, therefore, a period of fifteen days has elapsed, during 
which the persons are in the constant habit of purifying all the 
effects which they have brought along with them, and they con- 
tinue still in health, I would say that, in as far as regards the 
cause of suspicion, for which they were placed in quarantine, 
they are safe ; and that, if they unfortunately have contracted 
the malady afterwards, it must have happened from touching 
some impested person or thing whilst they were in quarantine, 
should plague have unfortunately broken out in that class. 
This may be considered as a matter of no consequence 
as affecting the patient himself, for it matters little to him 
whether he took the disease along with him or got it whilst 
in quarantine ; but although it is of no material consequence 
to the impested person himself which way the malady was con- 
tracted, it is of the highest consequence with regard to his house 
and property ; for, in the one case, the family must be con- 
sidered as impested, and treated as sucli ; and in the other, 
they ought not to be visited by the expurgators, if we are really 



28 



INTRODUCTORY DISCOURSE. 



certain that the house and effects have remained untouched 
from the time the family left them. To permit the expurgators 
to enter such a house, would be an unwarrantable injury to 
their property. 

With regard to the places proper for performing quarantine, 
I would, for many reasons, prefer tents to houses. They are 
more cleanly and airy ; can be made more insulated ; and, 
consequently, there is less risk in them than in houses of con- 
tracting the disease. Moreover, they can be so much exposed, 
as to be completely under our eye, so that nothing improper 
can be carried on in them, at least, during the day ; and these 
are all advantages which we cannot have in houses. It is 
necessary, of course, that the situation be healthy, and at a 
short distance from the hospital, or pesthouse, which I would 
recommend never to be in a town, if it can possibly be avoided ; 
that there be plenty of fresh water near it, as well for the pur- 
pose of ablution as for other uses ; that the whole establishment 
be insulated, and all approaches towards it carefully cut off. 
It would be desirable, if circumstances permitted it, that the 
position were close to the sea- shore. 

Quarantine establishments, whether they are intended as a 
protection against the inroads of plague, considering it as an 
imported disease, or in the acceptation most generally meant 
here — viz., as places where the health of the persons who are 
separated from the general mass of the people, on account of 
the suspicion of plague, is to be proved by time in an insulated 
situation — are to be kept sacred and inviolate. I shall enter 
more fully into the matter in the body of the work, as the sub- 
ject comes before me ; but I may here notice, by the way, that 
in the time of plague, the quarantine encampments, which, for 
various reasons, I would prefer to houses, ought to be well- 
guarded, night and day, by means of sentinels appointed for 
that purpose ; that one class ought not to be permitted to have 
any intercourse with another ; that the three grades, of positive 
plague, high suspicion, and simple suspicion, as also the addendum 



INTRODUCTORY DISCOURSE. 



•29 



with respect to doubtful cases, embrace everything necessary to 
secure the public health ; that, in fine, the classification under 
the different heads is the same, whatever numbers there are to 
be admitted. 

It is, however, necessary to keep in mind, that when the 
prevalence of the calamity renders it requisite to admit new 
cases daily into these different classes for a considerable length 
of time, (and such, when they occur, must be admitted under 
the heads I have mentioned,) the number thus admitted being- 
considerable, would cause no small confusion in the quarantine ; 
and this will undoubtedly be the fact, unless we are careful to 
prevent it. Proper attention not being paid to this particular 
was the cause of considerable inconvenience in Corfu. Yet, by 
a little attention and management, this matter may be rendered 
extremely simple and satisfactory. Suppose an encampment- 
ground, in which the positions for the different classes I have 
mentioned are prepared — the sick, for instance, in the hospital ; 
the highly suspected and the cases of simple suspicion in their 
own proper places ; and the doubtful cases apart from either. 
If the admissions are considerable, I would, every six or seven 
days, shut up each camp, or party, and allow no more admis- 
sions into it ; that is, I would shut it up, and perfectly secure 
it, day and night, by sentinels so stationed as effectually to 
prevent any intercourse from taking place with the other divi- 
sions or classes. Having done this, I would open new divisions 
of the same classes ; which, after a certain number of days, 
(the term to depend entirely on circumstances,) I would also 
shut up and secure as formerly. Thus, by continuing to do 
so as long as admissions continue to be sent in, the original 
classes would remain the same throughout ; while the divisions 
and subdivisions, no matter how numerous they be, would 
follow the same course, and would be kept perfectly apart from 
each other in strict quarantine. By these means, we know 
with certainty what is going on in all the different classes, 
divisions, and subdivisions. We know the accidents, whatever 



30 



INTRODUCTORY DISCOURSE. 



they may be, which occur in all of them ; which, if no inter- 
course has taken place, must be confined to their own proper 
division, without affecting any of the others ; and we keep a 
regular account of them. We know the day that such a divi- 
sion of such a camp was shut up ; and we are enabled, pretty 
correctly, to make some estimate of the health of the persons 
thus separated and segregated. But all these classes, divisions, 
and subdivisions, must be kept perfectly separate, or everything 
will go wrong. For if by any means they are mixed together, 
we cannot tell or know what may be the consequences ; for if 
disease breaks out, we shall then be thrown into a state of com- 
plete confusion, from which we shall not easily be relieved, 
as all calculations with regard to time and other circumstances 
will be wholly lost from the breaking down of the quarantine 
rules and regulations. 

If the classes are divided and subdivided in the way I have 
proposed, and kept distinctly apart, nothing like confusion can 
happen ; and those in quarantine may look forward with con- 
fidence to the period of their liberation, after a certain time, if 
they are free from disease ; which they could not do, if this 
system becomes deranged, and disease starts up indiscriminately 
here and there, without being properly accounted for. 

I noticed, in a passing way, that by not attending to the 
shutting-up of these camps every six or seven days, according 
as the admissions into them are numerous or not, much hard- 
ship and inconvenience may ensue ; and here I may adduce an 
instance of this. Before my arrival in the plague-district, 
constant and daily admissions had taken place, which, of 
course, protracted the period of liberation. At one time, in the 
camp of the simply suspected, there were persons who had been 
sixty days in quarantine, promiscuously mixed with those who 
had been admitted only a few days before. The people who 
had been longest in quarantine complained (and with reason) 
that they saw no *end to their confinement, in consequence of 
the daily admissions into their camp ; for every fresh admission 
vitiated its character. 



INTRODUCTORY DISCOURSE. 



31 



When I came to know the system that was carried on in this 
camp, I put an immediate stop to such a proceeding. 1 shut 
up that camp, and opened another division of the same class, 
into which all fresh admissions were received. After a few 
days more, I shut up that division also, opening another ; and 
so on successively, till all further admissions had ceased. As 
to the camp itself, in which such roundabout quarantine had 
been going on for so long a time, their period of quarantine 
was to be reckoned from the day of the last admission into it 
before its being shut up ; and as no accident of plague occurred 
from that time for forty days, the persons detained in it were, 
at the end of that term, sent back to their homes. I may here 
add, that in no case ought a camp to be left open longer than 
twelve or fifteen days. It were cruelty to the other persons 
who are in it to extend the time beyond that period. 

Every consideration of kindness and humanity ought to be 
paid to persons thus separated for a time from the community ; 
and every indulgence consistent with the public safety ought 
to be accorded to them in their unhappy situation. They 
naturally become easily alarmed and anxious. Their case is 
truly distressing, although the public safety requires their tem- 
porary separation ; and none but the callous-hearted and un- 
feeling would refuse to soothe and comfort them in their pecu- 
liarly trying situation. Their proper wants should be regularly 
supplied, and their galling chain made as light as possible. 

I have here much heartfelt satisfaction in recording publicly 
the very great exertions made by his Excellency the Lord 
High Commissioner and Major-General Sir Charles Phillips 
in not only supplying in the promptest manner the various 
wants of the inhabitants of Lefchimo during the time of their 
distress, but in even humanely anticipating them. And it is 
equal justice to mention the immediate attention that was always 
paid to my numerous requisitions for the public service by 
these officers, and by the senate of Corfu, without which it 
would have been impossible to have carried on the duty, or to 
have finished it in the prompt and satisfactory manner in which 



32 



INTRODUCTORY DISCOURSE. 



it was done. I was, indeed, so much satisfied with the way in 
which my demands were supplied, that I find amongst my 
papers the copy of a thankful acknowledgment of it to General 
Phillips, in my official dispatch of the 17th of April. To him, 
however, such acknowledgment was unnecessary, for no one 
could be more desirous than he was to expedite matters, and 
no one knew better how to accomplish the object in view. 

The system that has been not unfrequently resorted to, of 
burning people's houses and property, with the view, as has 
been unfortunately imagined, of putting an immediate stop to 
the ravages of the plague, cannot be deprecated too strongly. 
Nothing is more improper, or more likely to defeat the object 
intended. The burning of an infected house will not effectually 
destroy the contagion ; because, in nineteen cases out of twenty, 
everything susceptible is not effectually consumed, and the 
fomes of the disease may, and will remain in the articles that 
have escaped the fire ; so that, when these are handled after- 
wards, they will most assuredly reproduce it. An impested 
house may, therefore, be destroyed, so as to be rendered quite 
uninhabitable ; whilst the impested beds, for instance, may 
escape the fury of the flames. It is, therefore, quite obvious 
that the plan is in itself not only cruel in the extreme, but also 
ineffectual for the purpose intended. It is also highly im- 
politic, and apt to render the people desperate ; as well as to 
induce them to save what things they are able to secrete from 
the general wreck, and hoard them in a thousand ways, perhaps 
fully charged with the contagion of plague, and thus make them 
the means of future mischief. Nor ought we to be at all sur- 
prised that the people will not tamely submit to see their pro- 
perty destroyed and themselves reduced to beggary in a moment. 
Human nature cannot bear such treatment ; which is the more 
to be deplored, because unattended with any immediate benefit, 
and likely to lead to very fatal consequences in the end. 

I am induced to make these remarks, from knowing that soon 
after the plague broke out in Lefchimo, the system of burning 



INTRODUCTORY DISCOURSE. 



3:3 



was had recourse to, in order, as was imagined, to crush the 
disease at once ; and it is not too much to say, that it was not 
productive of good effects, but that, on the contrary, it was the 
cause of much serious vexation ; as the poor sufferers, amidst 
the general consternation, removed secretly from their burning 
houses part of their property, which was impested, and hid it 
in the earth, or threw it into the wells, in order to save it, 
where, I imagine, every article of a perishable nature was in a 
short time rendered useless. 

Nor was this secreting of goods confined to the inhabitants of 
the burned houses alone ; but some families, who were in health 
at the time, not knowing how soon their houses also might be 
denounced as impested, took the alarm, and anticipating what 
might perhaps happen to themselves some time or other, re- 
moved, and artfully concealed their property in like manner. 
Now, it was quite impossible to say with certainty whether the 
things thus hid were really impested or not ; for sometimes it 
turned out afterwards that infection lurked in these hoards ; 
and, indeed, it was known only to themselves what they had 
concealed, or where such effects were deposited. The conse- 
quence of all this was, that after the plague had, generally 
speaking, ceased, it started afresh whenever these hoards were 
interfered with ; and we were consequently obliged to call in the 
expurgators, who alone could be employed in this duty; and they 
were for a considerable length of time engaged in searching 
out these nests of concealed effects, in destroying them on the 
spot, or removing them to the general depot formed for the 
reception of impested things. And, in order to secure the 
public health against this concealed infection, the government 
found it expedient to issue various proclamations, which were 
read in all the villages of the district, in the camps, and even 
in the pest-hospital, calling on the people in the most urgent 
manner to tell where they had concealed anything; and to 
give additional force to these proclamations, the Bishop of 
Corfu issued his anathema against all those who refused to come 



34 



INTRODUCTORY DISCOURSE. 



forward and make the discovery. Even these strong measures 
were not effectual ; and it was not until I represented to Major- 
General Phillips, the locum tenens of the Lord High Commis- 
sioner, in the strongest manner possible, the necessity of granting 
some remuneration for the discovery of hidden goods, by way of 
compensation, that they came forward at last to make the 
wished-for disclosures. And for this purpose money was sent 
down to me, to be distributed among them, according to my 
discretion. It being, therefore, an object of the very first con- 
sideration to get at the bottom of these hoards of infection, 
or concealed goods, every one was promptly paid on the spot a 
certain value for the property discovered. That this had the 
desired effect, I am led to conclude from the continued freedom 
of the district from plague during the rest of the time I re- 
mained in Corfu, and up to the very period I am now writing 
this : for my belief was, that if these hoards of infection were 
not discovered, that plague would break out afterwards (and 
which in some instances we found to be the case) among the 
people when they came to look after their effects on then- 
return to their homes. Probably some of their things might have 
been so rotten or destroyed as to be no longer noxious : but it 
would have been bad policy to put the matter to the test, and 
the better plan was to burn them at once wherever they were 
found. The rooting out, therefore, of these nests of concealed 
goods, which, I may say, were spread far and wide, was no easy 
task ; and the state of anxiety in which we were all kept, lest 
everything impested had not been destroyed, was far from 
pleasant, notwithstanding that we were all on the watch to lay 
hold of the disease the moment it should anywhere make its 
appearance. 

It may, no doubt, be necessary in the time of plague, es- 
pecially at the beginning, to make severe examples of persons 
violating the laws of quarantine. Yet I am decidedly of opi- 
nion that the punishment of death ought never to be had 
recourse to but in cases of the greatest urgency, and then only 



INTRODUCTORY DISCOURSE. 



35 



for the sake of example. Hanging and shooting tend only to 
exasperate the people, and seldom prevent the commission of 
this crime. More will be done by mild measures, and ex- 
plaining to the people the reasons and necessity of acting as 
we do ; and by endeavouring to persuade them that we are not 
at all actuated by cruelty or malevolence towards them, but 
from a regard, not only to the public safety, but also to their 
own personal security and advantage. There are many ways 
of punishing, without having recourse to such extreme mea- 
sures. Still the people must be made perfectly to understand 
that whilst under quarantine restriction, which in its nature 
approaches to martial law, they cannot with impunity violate 
such restriction, nor make light of so sacred a law, but that the 
community at large, as well as they themselves in particular, 
are immediately concerned in its strict observance. That mild 
and conciliating measures will have the happiest effects, I can 
vouch from experience ; for, during the whole time of my resi- 
dence in Lefchimo, among a people no ways remarkable for 
tameness and obedience to orders, only one man lost his life 
for his refractory conduct. But this was a most hardened and 
unprincipled villain, who had been guilty of the greatest 
excesses, as will be seen in the narrative. 

In the time of plague, as well as in the time of warfare, it 
must be expected that much valuable property will be destroyed, 
and some of it, perhaps, in a wanton and unnecessary manner, 
which it is not always in our power to prevent. This destruction 
of property of a susceptible nature, or such as is capable of 
retaining and propagating the plague, is owing to the impos- 
sibility of ascertaining with precision the things which contain 
the fames of the disease, and of separating them from those 
which do not. On this head, much, therefore, rests entirely on 
suspicion, and perhaps but a small portion on positive certainty. 
Thus, in an impested house, the clothes immediately about the 
sick, and many of the things in their chambers, are no doubt 
positively imbued with the matter of plague, and respecting 



36 



INTRODUCTORY DISCOURSE. 



them, there can be no manner of doubt. They ought, there- 
fore, to be immediately set apart for purification, or to be 
destroyed,, as may be deemed most proper. With regard to 
many other things, it is evidently probable that they may not 
be impested ; but as it is, we have no means of ascertaining 
the fact. And as not even a chance of the pestiferous matter 
remaining in anything in the house can be allowed, by the laws 
of quarantine, there is no other alternative than to treat the 
whole house and its contents as impested, purifying or destroy- 
ing every part of the susceptible furniture, and perfectly ex- 
purgating, white -washing, and fumigating the house itself, so as 
not only to destroy the bad air in the sick chambers, but also 
to remove every article, and even the minutest rag which is 
capable of retaining the matter of plague ; by doing which, we 
effectually purify that house, even under the very worst possible 
circumstances, and render it again habitable. 

The disposal of susceptible property in the time of plague is 
a most important object of consideration ; and notwithstanding 
all our care to prevent it, there is room to fear that a great deal 
of it will be unnecessarily destroyed. On this head only general 
directions can be given. But it is undoubtedly the imperative 
duty of every one concerned in the expurgation to do everything 
in his power, consistent with the public security, to preserve 
such property. And if such do their duty, much unnecessary 
and wanton destruction will be prevented. 

In the beginning of plague, as well as during the whole pro- 
cedure, much is to be done towards preventing the destruction 
of property by timely and good management. With this view, 
depots ought to be early formed for the reception of the effects 
belonging to families who may be unfortunately attacked by 
the disease ; and as much as possible, the property of every 
family ought to be kept separate and distinctly marked, to pre- 
vent all mistakes ; some account, too, of it ought to be taken 
by the persons in charge. 

I am aware that there is a considerable degree of trouble 



INTRODUCTORY DISCOURSE. 



37 



attending this operation ; yet I am perfectly convinced that it 
may be accomplished, in a great degree, by proper manage- 
ment, and without much danger to the persons employed, pro- 
vided they take proper care of themselves. By this, two very 
essential objects are attained : first, we remove everything 
capable of propagating the disease, and place it where it can 
do no harm ; and, secondly, we have the satisfaction of saving- 
much valuable property, part of which, at least, may, perhaps, 
be purified with very little trouble, and no danger, at any time, 
such as plate, &c. ; whilst the remaining things, which are con- 
sidered worth the expense, may be purified afterwards. I need 
hardly add, that these depots ought to be guarded with the most 
jealous care. 

Great temptation is no doubt thrown in the way of the per- 
sons employed in the transporting and purifying of these goods ; 
and when, generally speaking, we consider the moral character 
of those performing this service, we cannot trust much to their 
honour and honesty. But if the police regulations respecting 
them are as strict as I suppose them to be, they ought not to 
have an opportunity of stealing or secreting anything. They 
might possibly contrive to hide silver or gold in the earth ;* 
but as I take it for granted that no intercourse whatever is 

* The secreting of anything is no doubt a loss to the proprietor, which, if 
possible, ought to be prevented. But the concealment of things of a nature, I 
had almost said, incapable of producing the disease — such as silver, gold, &c, 
when nothing susceptible is attached to them — is to be viewed, in as far, at 
least, as regards the public health, in a very different light. The purloining 
of such things, of whatever consequence to their owners, can be but of small 
import to the community compared with that, for instance, of linen, cotton, 
and things of that kind, which are known to be most susceptible of catching 
and retaining in them the virus. For, in the first case, the articles may be 
safely removed with a pair of tongs or pincers, and dipped into vinegar, or 
into soap and water, and washed, without danger ; but in the other, they 
cannot be handled, or even touched, without risk ; and they, therefore, ought 
to be immediately destroyed or purified with all due precaution. In the one 
case, also, there is nothing to fear afterwards, unless they be wrapped up in 
things of a susceptible kind ; but in the other, there is great danger to be ap- 
prehended of the calamity starting up afresh whenever they are touched again. 

E 



38 



INTRODUCTORY DISCOURSE. 



allowed to exist between them and other persons beyond the 
insulated pest establishment, or between persons so highly sus- 
pected and the healthy, they cannot have an opportunity of 
conveying it away until the final winding-up of the whole busi- 
ness, when they are to be liberated. And as we have then an 
opportunity of narrowly examining them and everything they 
possess, we can easily detect what does not belong to them. 

With regard to the property of such as are simply suspected, 
it ought not to be removed from their houses, at least, not in 
the first instance. It should be kept in mind that theirs is only 
suspicion, and that they may not be impested. It would, there- 
fore, be hard indeed, and unjust, to subject them to all the 
vexations attendant on positive plague. Should positive plague 
break out amongst them afterwards, and when it can be satis- 
factorily ascertained to have been brought along with them, and 
not contracted during the time of their segregation, then, in- 
deed, their property must be considered as impested, because 
they brought the disease along with them. It is reasonable, then, 
to suppose that the plague is in their house, and the public 
security requires that the proper means should be adopted to 
prevent its spreading, by the immediate removal of their im- 
pested effects. But if, on the other hand, there is every reason 
to believe that they have contracted the disease whilst in obser- 
vation, we are to conclude that their house is not impested, 
and, consequently, not to be interfered with. 

In order to prevent the mistakes which would happen, should 
the simply suspected houses unfortunately be confounded with 
those known to be positively impested, and by which clean houses 
may be entered by the expurgators, and treated as if they had 
been originally affected with plague, to the unavoidable destruc- 
tion of property, every suspected and impested house ought to be 
particularly marked in some conspicuous part of it ; say with 
a yellow cross for the suspected houses, and with a black one 
for those positively impested. Should it happen afterwards that 
the house, which was only suspected at first, becomes, from 



INTRODUCTORY DISCOURSE. 



39 



subsequent circumstances, known to be positively impested, then 
the case is entirely altered, and the yellow mark of suspicion 
must be replaced by the black, which indicates the existence 
of the plague there ; and no time should be lost in affixing it, 
in order to prevent mistakes, and guard every one from entering 
it, until it is expurgated by the proper persons.* 

It is specially to be required that the expurgators do not 
enter into any non-impested house; because, as every one of 
them (the expurgators) is supposed to be charged with the 
pestiferous matter in their clothes, if not in their system, it is 
very evident that they cannot enter a house, or at least touch 
or handle the susceptible goods, without the risk of bringing 
disease into a dwelling otherwise free from it. Circumstanced, 
therefore, as expurgators are, they must absolutely have nothing 
to do with the non-impested houses ; for if they have, such 
houses must be considered as contaminated, and treated ac- 
cordingly : for high suspicion ought invariably to attend all their 
movements. Indeed, no class of persons require to be more 
strictly guarded, or better looked after, in time of plague, than 
these ; for they must all be considered as firebrands, capable of 
spreading the disease, and communicating it to whatever per- 
sons or things they may happen to touch ; and as such, they 
are to be most scrupulously avoided at all times, and kept 
apart by themselves. 

General Phillips considered the guarding of these men with 
the most jealous care as a matter of such high importance in 
the plague of Lefchimo, that a commissioned officer and a party 
of soldiers were expressly appointed for this duty, in addition 
to a police-guard, which had been sent down for that purpose 
from Corfu ; and on whatever service the expurgators were em- 
ployed, they were invariably accompanied by these guards, who 

* I am aware that the directions I give here do not embrace every contin- 
gency which may happen ; and much is to be left to the discretion of those 
employed to conduct this service. The general principles, however, are the 
same in all cases, and must be acted upon. 

E 2 



40 



INTRODUCTORY DISCOURSE. 



never left them or lost sight of them night nor day. In some of 
the various duties which they had to perform, it became neces- 
sary to lodge them altogether (indeed, this ought always to be 
done, if possible) in some secure place, such as a church, or in- 
sulated house, till the duty was over, when the place which 
they had occupied was always white-washed, and fully ex- 
purgated, under the directions of one of the chief expurgators, 
before they quitted it. 

It was from a laxity of discipline in this respect that the 
village ofArgirades became impested after it had been a con- 
siderable time free from plague. Previously to my taking charge, 
one of the persons employed on the service of expurgating the 
houses there having become very popular among the inhabitants 
of that village, was in the habit of clandestinely visiting at their 
houses, the people conceiving that, as he appeared to be in 
perfect health, there was no danger in associating with him. 
This man had been for some time employed on that duty, and 
having hitherto escaped with impunity, he became fearless ; 
and thinking the usual precautions unnecessary, doubtless en- 
deavoured to persuade the villagers that there was no reason 
to be afraid of him, or to avoid him, as he had continued the 
whole time in perfect health. This foolhardy confidence in 
himself, from his having hitherto escaped the contagion, ren- 
dered him careless of his own safety, and consequently less 
prudent than he had been at the commencement. He con- 
tracted, at last, the disease, and died of it ; but what was most 
to be deplored, he communicated the distemper to all the 
families with whom he was in habit of intercourse ; so that this 
mutual violation of the laws of quarantine cost that unfortunate 
village the loss of many lives before the evil was got under. 
This man was guilty of a breach of trust, for which, if he had 
escaped, he ought to have been most severely punished. But 
the people themselves were also greatly to blame for associating 
with one whom they had been repeatedly warned to avoid- 
They would not, however, believe the necessity of attending to 



INTRODUCTORY DISCOURSE. 



41 



such advice until they were taught by dear-bought experience 
the sad consequences of neglecting it. 

In this case, which must appear a very conclusive one, we 
see the fatal effects arising from what some may perhaps con- 
sider a very trifling matter ; and we may learn from hence, as 
well as from innumerable other instances, which are equally 
strong, that we cannot with impunity have communication 
either with expurgators, or with persons who have had the 
plague in their families, until a certain time has elapsed, during 
which they must be kept in strict quarantine. Nor is it any 
argument to the contrary, that in numerous instances those 
who have had such communication have escaped all harm. 
The plague is decidedly a contagious disease, and only to be 
combated with that view ; so that, if we wish to avoid it, we 
must shun all contact with impested persons and effects, and 
with those even suspected of being so. 

There is this peculiarity in plague in which it differs from 
all other diseases, and, I had almost said, from everything in 
common life — that there is scarcely any circumstance connected 
with it which can be called trifling, or of no consequence. 
Matters which, to the eye of a common observer, merit little or 
no attention, are to those versed in the police management of 
plague, fraught with the most important consequences ; and it 
often happens that it is a minute attention to these supposed 
trivial matters which makes the great difference between effi- 
cient and inefficient arrangements. 

Nor is it from any want of laudable zeal among those en- 
gaged in the police treatment of this malady that things some- 
times go wrong ; for even this inestimable quality, unless guided 
by judgment and experience, will perhaps be productive of un- 
happy consequences, and may lead to unjust conclusions re- 
specting the nature and character of the disease we are con- 
templating. It is, therefore, only by the combination of these 
requisites, added to patience, constant activity, unwearied per- 
severance, and a strong mind, that we are to expect to subdue 



42 



INTRODUCTORY DISCOURSE. 



eventually, this formidable and relentless enemy. And in the 
execution of this duty, I do not hesitate to say, that no one 
must expect to recline* on a bed of roses, but that they must 
make up their mind to endure much harassing fatigue and 
anxious care, together with numberless privations, to bear up 
against which will require all their philosophy and fortitude. 

From what has been already said respecting the indispen- 
sable necessity of separation and segregation in the time of 
plague, as the only effectual means of combating the enemy, 
it will be perceived that this principle ought to be as vigorously 
carried into effect as possible, from the time that the existence 
of plague is proclaimed. 

It is with this view that the shutting up of the people in their 
houses has been strongly recommended, and, in some instances, 
acted upon. It would, indeed, be a most happy circumstance 
could this shutting up, as it is called, be early and satisfactorily 
carried into effect ; and that it were not a nominal, as there is 
reason to suspect has been the case on more occasions than 
one, but a real shutting up — a perfect seclusion and separation 
of families from each other for a time. If it were actually so, 
the good effects of the system would, in due time, be made 
manifest, by the speedy arrest of the disease, and the safety of 
those insulated, provided they were free from the contagion of 
plague at the time of their segregation. I am decidedly of 
opinion that the principle is good, although, from want of energy 
in carrying it into full effect, it has been branded with the re- 
proachful epithets of cruel and inefficient. But the truth is, 
that, if properly conducted, it is neither the one nor the other, 
but a measure fraught with the greatest benefits to the com- 
munity, as it renders nugatory, in a great degree, the baneful 
influence of this invisible enemy, and, consequently, diminishes 
its mortality. In the memorable plague of Marseilles, of which 
so much has been said, the system of shutting up the people in 
their houses was alleged to have been fully acted upon, and 
to have failed. Yet there are the strongest reasons to suppose 



INTRODUCTORY DISCOURSE. 



43 



that the shutting up there was merely nominal, for intercourse 
to a very melancholy extent did take place between the people 
thus shut up, and whole families were overwhelmed with the 
plague. And not only this, but the people escaped from the 
city itself, and spread the disease in the neighbouring towns. 
From the want of vigorous measures in the first instance, this 
city became overpowered by the malady — all was confusion 
and consternation there ; and, in fact, it was found at last 
utterly impossible to stem the torrent, as every restraint had 
been completely broken through by the destruction of the officers 
of health themselves. 

Nor was this the case only in Marseilles, but it was also, 
though perhaps in a less degree, the case in the plague of 
London, in 1666, as well as in that of other places, and from 
the same cause too — namely, from the want of a properly or- 
ganized and efficient police. It is, doubtless, true that the 
system was not so well understood at the periods I mention as 
it is at the present day ; and to this cause its failure may be 
attributed. But that is no reason for stigmatizing a plan 
which, in more recent instances, has had the happiest effects in 
arresting the progress of the calamity. 

As to the provisioning and supplying the wants of the people 
thus insulated, that is entirely an affair of the government, with 
which I have nothing to do, and must depend on circumstances, 
which it is unnecessary to enter upon here. I may, however, 
mention, that above twenty villages and towns in Lefchimo 
were, for a great part of the time, almost entirely dependent 
for the supply of all their immediate wants upon the govern- 
ment ; and everything was regularly forwarded as required, and 
without danger to the persons employed in this brarch of the 
service. 

Connected with this part of the subject is the partitioning an 
impestcd city or town into districts or divisions, each of which 
ought to be perfectly separated from the other, and no inter- 
course whatever allowed between them — that is, no communica- 



44 



INTRODUCTORY DISCOURSE. 



tion permitted by which the contagion of plague can be hn- 
ported from one place to another. Nor is this at all a chi- 
merical project, or impossible to be accomplished ; for the 
dividing the city of Valetta into sections dming the plague in 
Malta was adopted, and with the best effect in checking the 
malady there. A vigilant and faithful police will do a great 
deal towards realizing it. And should the people at any time 
evade the activity of the police, they will themselves soon be 
made sensible of the impropriety of their conduct by sad ex- 
perience, were they even immediately to escape the punishment 
awarded against their violation of the laws of quarantine. 

In mentioning a vigorous police, and energetic measures for 
the restraining of plague, I would be understood to mean 
principally an efficient military force, on which we can 
depend for the accomplishment of the objects we are desirous 
of carrying into effect. This is perfectly indispensable in the 
management of plague ; yet a great many things may be done 
by confidential civilians, which, indeed, are not to be trusted to 
a military force. 

I will not in this place enter into the various duties which 
fall to the lot of the one or the other, as that must entirely 
depend on circumstances, and will be detailed in another part 
of this work. I, however, may say something with respect to 
cordons ; by which I mean troops employed for the purpose of 
effectually cutting off any place attacked by plague, so as to 
prevent it spreading beyond its proper limits, either by the 
escape of persons actually labouring under the malady, or of 
those who may have the seeds of it in their system or in their 
clothes, or by permitting susceptible things, which may be im- 
pregnated with the effluvia of the plague, to pass beyond certain 
limits. For by all these modes the disease is to be propagated, 
and they therefore ought to be prevented. If a cordon is so 
stationed as effectually to prevent every intercourse, except 
under the laws of quarantine, between an impested place (no 
matter whether it is a city, town, or district of country) and 



INTRODUCTORY DISCOURSE. 



45 



places which are healthy, and should the persons employed on 
that service do their duty, I will venture to affirm that no state 
of the atmosphere will extend the disease beyond the cordon, 
provided that it has in the first instance been so stationed as to 
have left no plague in its rear. Still, however, should the 
people by any means escape from the impested place, or should 
impested goods be carried beyond its limits, then, indeed, the 
precaution taken ceases to have its proper effect, and the 
disease will be propagated in the direct line of the communica- 
tion. 

In the plague of Corfu, the cordon, which was established at 
Messongie, to prevent all intercourse betwixt the district of 
Lefchimo and the rest of the island, was completely successful ; 
and during the whole time it occupied its position, not a single 
individual, nor a single article of any description, was allowed 
to pass beyond it from the impested district, nor even imme- 
diately to approach it. The consequence was, that not one 
case of plague ever occurred in any other part of the island, 
although the malady was raging in almost all the villages 
of Lefchimo. If any doubts arise as to the efficiency and 
use of a cordon in plague, I rerjly at once that both were 
evidently manifested here ; for if such had not been established 
and defended with the most jealous attention, there can be no 
doubt whatever but the malady would have extended itself over 
the other parts of the island, as it was actually doing over the 
villages in the interior of the district, according as intercourse 
between those who were healthy and the impested took place, 
before the means of cutting them off from one another, and the 
principles of separation and segregation, were fully acted upon. 

In the plague of Corfu, the police regulations were arranged 
in such an efficient manner, and executed with such vigour and 
strictness, yet with such humanity and consideration for the 
unfortunate people — whom it was found necessary to place 
under restraint, for their more speedy deliverance from this 
dreadful calamity — that I presume I may be allowed to say 



46 



INTRODUCTORY DISCOURSE. 



that the case has seldom been equalled, and could not well be 
excelled ; and to that system, planned and fully carried into 
effect under the directions of the Lord High Commissioner Sir 
Thomas Maitland, and General Phillips, is to be attributed the 
successful manner in which the plague was immediately checked 
and finally put down. 

To show how the intercourse between myself and the govern- 
ment was carried on, and which took place every day under 
the restrictions of quarantine, I may mention that the Orderly 
dragoon who carried my dispatches, which were put into a 
sealed tin case, was obliged to deposit them at the barrier of 
the cordon, at a place called Messongie, from which they were 
forwarded to head-quarters in Corfu ; whilst the same precau- 
tions were adopted with respect to the orders and instructions 
which were sent to me from thence. The dragoons in neither 
case ever exceeded or entered the impested district. Equal 
precautions were taken within the district itself. All reports 
from the district were brought to me and said to have been 
properly fumigated ; but I did not trust to this. I received 
them with my long iron pincers, and fumigated them myself. 
Having read them, I gave the necessary orders, if any were 
required, either verbally or in writing, and dismissed the 
guardianos. Thus I was living in the midst of a large plague 
district, with some fourteen towns and villages either positively 
impested or under high suspicion, superintending the manage- 
ment of the whole operations, and as much insulated or cut off 
from all society as if I had been in a wilderness ; for I had no 
communication or contact with any one. not even to shake 
hands with, from first to last, until free pratique was proclaimed 
between Lefchimo and the rest of the island. The only excep- 
tion to this was my servant, who was at once my cook, my 
washerman, and my groom, who, from a circumstance re- 
lated elsewhere, was kept constantly under the eye of my guard. 
This he thought a hardship at first, but latterly he became 1 
reconciled to it, and kept at home, which he did with more 



INTRODUCTORY DISCOURSE. 



47 



contentment, from knowing the mischief which was going on 
around him. 

In this service, it was not my duty to attend the plague 
patients, nor was it intended that I should do so, as I had an 
Italian doctor, a volunteer, for that special duty ; but in case of 
his falling sick, and being unable to attend the patients, it 
would have been my painful duty to have sent in another ; this, 
however, was not necessary, as he continued in health to the 
last. 

Had either myself or any of the other medical officers, dis- 
persed as they were over the district, caught the disease, it 
would have been a very untoward circumstance in every point 
of view, as it would in some degree have suspended the plan 
of operations then going on, for a time, and perhaps thrown a 
certain doubt and discredit on them. 

In the establishment of what I may call a general cordon, for 
effectually cutting off a district of country from the part that is 
healthy, or at least free from all suspicion of plague, care must 
not only be taken that there is no plague left behind, 
but that the troops forming the cordon do not themselves 
occupy houses or huts which may have been impested, and 
have not been expurgated ; else they may get the plague, 
and thus materially increase the evil which they are intended 
to prevent. I would therefore recommend that, instead of 
their occupying any houses, they should be encamped, as a 
more certain means of precaution. Should it happen that, 
from defective information in the first instance, the position of 
the cordon has not been properly chosen, and that it is found 
out afterwards that the plague has broken out in its rear, it 
must be thrown back, and another position taken up ; for the 
plague must not exist behind it. 

It will be perceived that by the word cordon, I do not mean 
lines of circumvallation, ditches, or walls, but an efficient mili- 
tary force. This is assuredly the best cordon; and if they do 
their duty, will be completely successful. The former, however, 



48 



INTRODUCTORY DISCOURSE. 



may in some cases assist, and render fewer troops necessary. 
But this matter depends so much on local circumstances, that 
no directions on the subject can be given. 

Having said this much on the establishment of a general 
cordon for the protection of the healthy part of a country, I will 
now add a few observations on the precautions which it may 
be necessary to take in the interior of an impested district. 

Every impested city, town, and village where the plague has 
made its appearance, ought to be immediately insulated, if we 
have the means of doing so. Troops ought to be placed, and 
such other means adopted, as effectually to cut off all inter- 
course between such places. In some cases, as in fortified 
towns, this may be easily prevented. And if the guards are 
but faithful to their trust, neither the people can escape to 
spread the mischief, nor can impested things be thrown from 
the walls ; nor, if the people are shut up in their houses, which 
I suppose to be the case, will the number of troops required be 
so great as one is apt to imagine. 

In Lefchimo, we found that an active officer with from fifteen 
to twenty men were quite sufficient to keep in order the largest 
village ; whilst in the smallest villages only a steady and con- 
fidential non-commissioned officer with five or six men were 
required. Hence, they generally lived in the impested vil- 
lages, but in houses previously expurgated, and were continually 
on the outlook, to preserve order and a strict compliance with 
the rules of quarantine ; and happily with the best effects. But 
although shut up in their houses, the people were not prevented 
from assisting themselves in the various ways which were con- 
ducive to their comfort ; nay, on the contrary, every facility for 
their doing so was granted, provided no intercourse took place 
amongst them, or rather, amongst their different parties, when 
so employed. 

I am quite aware that discredit has been thrown on the 
system of cordons and shutting-up in time of plague by those 
who do not believe in the doctrine of contagion ; and, indeed, 
numerous instances are recorded in which such measures have 



INTRODUCTORY DISCOURSE. 



49 



failed. But I still maintain, that in all the instances adduced, 
the fault has been, not in the system, but in the imperfect 
manner in which it was executed ; and this, of course, is to be 
expected. Yet it is very singular, that in some of those very 
places where we are told they have been useless, and odium 
thus thrown on the plan, the indispensable necessity of which I 
am now advocating, we find that persons who were known to 
have voluntarily shut themselves up and avoided all intercourse 
from the beginning, have remained in perfect health, when the 
general havoc made by the distemper has been dreadful. This 
I impute entirely to their perfect seclusion, and to no other 
second cause. If people would but reflect well on the cases of 
exemption which they witness in the time of plague among 
those who carefully avoid all intercourse and fully act upon that 
system, they themselves would be tempted to adopt it; and 
in doing so, would certainly experience the greatest benefits 
accruing from it. 

Discredit from other powerful causes has been also thrown 
on the principle of shutting-up. It has almost invariably hap- 
pened, that in the houses which were shut up, the sick were no* 
removed, but left there, promiscuously blended with the healthy. 
No wonder, then, if the disorder was thereby rather increased 
than diminished. To have sick and healthy together, after 
plague is ascertained to exist, is little less than downright 
murder. People, also, who have voluntarily secluded them- 
selves, have soon after got the plague amongst them. This, 
however, is to be attributed to their having had the contagion 
in the system before they began to insulate themselves, and 
not having taken the necessary precautions against it. It 
has no doubt happened, too, that even with all their care, some 
families have become impested at a time when they thought 
themselves quite secure, from the misconduct of servants, or 
some other violation of the laws of quarantine. But it would 
be too absurd to stigmatize the general system on account of 
these causes, which speak for themselves. 

It is necessary I should say something in this place on con- 



50 



INTRODUCTORY DISCOURSE. 



centration in the time of plague, although, from what I have 
already advanced, it will clearly appear that concentration is 
the great object I have in view — namely, the removal of positive 
disease, wherever it may occur, into one place, as well as of 
those on whom suspicion alone rests into another, according 
to their grades. When General Phillips was nominated to the 
ordinative direction of the plague concerns in Lefchimo, one of 
his first acts was to unite the pest hospitals and the persons 
performing quarantine, who were spread over different parts of 
the district, into one place, thereby cutting off the possibility 
of any intercourse betwixt those magazines of contagion and 
the neighbourhood ; for every one of those places was to be 
viewed as a hotbed of plague ; and although they were well 
guarded, yet, separated as they were, they remained each a 
distinct focus, from which danger was to be apprehended, in 
case they should be interfered with. Moreover, by this step, 
the military duties, which at that time were very severe, were 
greatly diminished, as also the risk from the numerous sources 
of disease. 

The whole of the plague patients were thus removed into 
one hospital, and the other grades into quarantine near it, by 
which means the sick and the suspected were at once separated 
from the community. The removal of these persons, consider- 
ing our limited means of transport, and the necessity of keeping 
the different classes entirely separate, was a very troublesome 
task, but it was happily carried into effect without loss of life. 

Except, therefore, when an extensive tract of country is over- 
run with plague, and the great distance from the pest-hospital 
and quarantine establishments render it impossible to convey 
the sick and those under suspicion to their proper places, this 
concentration is always to be attended to ; and even in cases 
where, from circumstances, it is necessary for the present moment 
to establish more hospitals and quarantines than one, it will be 
found proper to unite them as soon as possible. 

In uniting these pest-hospitals and quarantines, every care 



INTRODUCTORY DISCOURSE. 



51 



should be taken in the removal, so that no one class be mixed 
or blended with another. It will be proper, therefore, to begin 
first with those under simple suspicion^ then with those of high 
suspicion, and, lastly, to remove the sick themselves and the 
hospital servants. It will also be prudent, not only on account 
of the persons themselves, but also on that of others, that they 
be properly guarded, and not permitted to straggle from their 
respective parties ; that impested articles be not strewed on 
the road ; and that, on their arrival at their places of destina- 
tion, everything be ready for their reception.* 

As soon as these movements are completed, it will be neces- 
sary, also, to concentrate the impested goods which had been 
placed in the depots, which I have already mentioned should 
be established at an early period for their reception. 

The work of expurgating the impested houses should be 
going on, and everything made clean. Should transient cases 
of plague occur, they are to be treated in the way I have men- 
tioned. All are to be sent to their proper places ; and by thus 
separating disease and everything connected with it, we may 
expect, in a short time, effectually to destroy the formidable 
enemy. 

It is also proper that I should say something on expurgation 
in time of plague. This operation is to be considered under 
two distinct heads : first, the expurgation of houses in which 
the plague has existed ; and second, the expurgation of all sus- 
pected property capable of receiving and retaining the fomes of 
plague. 

1st. With regard to the former, it merely consists in the re- 

* I begin with the simply suspected and finish with the sick and hospital 
servants, because I am unwilling that the former should be exposed to any 
risk from impested things ; which might possibly be the case should the sick 
be the first removed, as these might carelessly drop or scatter impested articles 
on the road, which the others following them might pick up, or inadvertently 
touch, and thus catch the disease. If, however, there be two roads to the pest 
establishment, to which they are to be removed, it will be as well to begin with 
the sick. 



52 



INTRODUCTORY DISCOURSE. 



moval of every article of a susceptible nature, however minute, 
from every part of such house, which is afterwards to be per- 
fectly cleansed, repeatedly white-washed, fumigated, and ven- 
tilated. 

2nd. Respecting the second, more care and attention is re- 
quired, so as not materially to injure the effects in this opera- 
tion ; and, indeed, the expurgation ought to be performed by 
those versed in this matter. Many things, such as linens, 
cottons, laces, woollen goods, &c, may be purified without their 
receiving any damage, by being put into caldrons of hot water 
and soap for a short time, and then exposed to the air till they 
are dry. I should think that this operation performed once 
would be sufficient to destroy any pestilential contagion which 
might remain in them. Moreover, there is no harm in repeat- 
ing it again and again if it is thought necessary. 

Gold and silver, or things of that kind, may be sufficiently 
purified by washing them well in vinegar and hot water. If 
any tiring of a more susceptible nature is attached to them, such 
as thread, strings, &c, they must be cut off without touching 
them, and immediately destroyed. 

Papers of consequence (and one would scarcely wish to be 
at much trouble except with such) are to be immersed in clear 
vinegar and water, and afterwards dried on a wire-grating over 
the fumes of sulphur, or such other fumigating materials. This 
will be sufficient to dissipate or destroy any contagion which 
may be attached to them ; and if due care is taken in their 
fumigation, they need not be injured in this process. 

Respecting many articles considered capable of retaining 
contagion, and, consequently, of propagating disease, authors 
are at some variance ; but all those who believe in the doctrine 
of contagion in plague, warn us particularly against cotton, 
woollen, and linen goods, silks, hair, feathers, and things of 
that kind, as being not only capable of receiving the contagion 
readily, but also of retaining it for a considerable time — indeed, 
for an unknown period, and of thus producing the disease after- 



INTRODUCTORY DISCOURSE. 



53 



wards. We are therefore to be on our guard against the 
touching of such articles, not only in the time of plague, should 
any suspicion exist of their containing the fomes of this evil, 
but we must also be particularly careful ?n expurgating them 
when they are imported to us from plague countries when 
plague exists there. 

In the management of plague, however, we have one decided 
advantage over the ancients ; and that is, we can suppress, and 
finally extinguish it forcibly wherever it appears, either in a 
lazaretto, town, or district of country, which we can insulate by 
the early application of the proper means, and not permit it 
now to depopulate cities, and, I may almost say, whole nations, 
as heretofore. But although the general plan of operation is 
the same in all cases, the particular mode of application, as 
well as the length of time required to continue it, will depend 
on circumstances, which it is impossible here to enumerate. 

Before concluding the introductory part of this subject, it 
may not be improper to cite the report of the select committee 
of the House of Commons, specially appointed to investigate 
the validity of the doctrine of contagion in plague ; and in the 
course of the work, I shall offer such remarks upon it as im- 
mediately present themselves and are connected with it. 

" Report from the Select Committee on the doctrine of Con- 
tagion in Plague. Ordered by the House of Commons to 
he printed, iith June, 1819. 

" Your Committee being appointed to consider the validity of 
the received doctrines concerning the nature of contagious and 
infectious diseases as distinguished from other epidemics, have 
proceeded to examine a number of medical gentlemen whose 
practical experience or general knowledge of the subject ap- 
peared to your Committee most likely to furnish the means of 
acquiring the most satisfactory information. They have, also, 
had the evidence of a number of persons whose residence in in- 
fected countries, or whose commercial or official employments 

F 



54 



INTRODUCTORY DISCOURSE. 



enabled them to communicate information as to facts, and on 
the principle and efficacy of the laws of quarantine ; all the 
opinions of the medical men whom your Committee have ex- 
amined, with the exception of two, are in favour of the received 
doctrine that the plague is a disease communicable by contact 
only, and different in that respect from epidemic fever. Nor 
do your Committee see anything in the rest of the evidence 
they have collected which would induce them to dissent from 
that opinion. It appears, from some of the evidence, that the 
extension and virulence of the disorder is considerably modified 
by atmospheric influence ; and a doubt has prevailed whether, 
under any circumstance, the disease would be received and 
propagated in the climate of Britain. No fact whatever has 
been stated to show that any instance of the disorder has 
occurred, or that it has ever been known to have been brought 
into the lazarettos for many years. But your Committee do not 
think themselves warranted to infer from thence that the disease 
cannot exist in England, because, in the first place, a disease 
resembling in most respects the plague is well known to have 
.prevailed here in many periods of our history, particularly in 
1665-6. And further, it appears, that in many places, and in 
climates of various natures, the plague has prevailed after in- 
tervals of very considerable duration. 

" Your Committee would also observe, that down to the year 
1800, regulations were adopted which must have had the effect 
of preventing goods infected with the plague from being shipped 
directly for Britain ; and they abstain from giving any opinion 
on the nature and application of the quarantine regulations, as 
not falling within the scope of inquiry to which they have been 
directed. But they see no reason to question the validity of 
the principles on which such regulations appear to have been 
adopted." 



TREATISE ON THE PLAGUE, 

ETC. 



PART I. 



ON THE NATURE AND QUALITIES OF PLAGUE, 



CHAPTER I. 

Diversity of opinion respecting plague — Considered a disease depending on 
contagion — Persons, however, sometimes escape it, though in close contact 
with plague -patients — Ancients of the opinion that plague is contagious — 
The word plague used indefinitely by them — They were unable to account 
for its introduction into a place — This circumstance explained by moderns 
on the principle of contagion — The true plague well known to the ancients 
— They were aware of its being propagated by intercourse with the sick, 
though probably not so that it could be introduced by persons or effects 
coming from a distant place where plague was raging. 

There is, perhaps, no disease or calamity with which we are 
acquainted that has engaged more of the attention of the medical 
historian than the one which we are now about to consider ; 
nor any one concerning which such a variety of discordant and 
opposite opinions have been given — opinions which, even at 
this day, and at this enlightened period of medical history, are 
not, perhaps, fully and satisfactorily settled and agreed upon. 
This is the more to be wondered at, as no disease, or class of 
diseases — except, perhaps, the small-pox and the cholera* — 

* This was written before the Asiatic cholera was much known in India, 
and before it had made such extraordinary ravages in Europe. 



56 



NATURE AND QUALITIES OF PLAGUE. 



has ever made half the havoc among mankind which this one 
has ; and it is allowed by all who have ever written upon this 
subject, that none have set more completely at defiance the 
ordinary rules and practice of medicine in all ages than this 
same disease : for, however writers have differed in opinion 
respecting its general character, I believe I may say almost all 
of them have unhesitatingly declared it to be most intractable, 
as far as regards the mode of cure. 

It is not my intention to enter into any speculative opinions 
respecting contagious or infectious diseases generally, or to 
draw a parallel betwixt them and plague, but I will at once 
consider plague as a disease depending on contagion alone* — 
as a disease sui generis, which, perhaps, is inimical only to man, 
governed by its own peculiar laws — differing essentially from 
all other diseases with which we are acquainted, and yet par- 
taking, in some respects, of the character of almost all of them. 
This subject is highly interesting to mankind, and one on 
which the welfare and happiness, not only of individuals, but 
of whole nations, depend. 

In considering the plague as a disease depending on contact 
alone, and by that means propagated from one individual to 
another, I do not hastily adopt that opinion ; but I conceive I 
am fully borne out in that point by many respectable authors 
of antiquity as well as modern writers, who, from their situation 
and the opportunities they have had of seeing the disease in 
question, and of investigating its nature and character, were 

* The evidence of Sir James McGregor before the committee of the House 
of Commons with regard to the plague being communicated by contact, is so 
clear and satisfactory, that I think no one can read his examination and doubt 
the fact. The evidence, also, of Dr. Frank is very conclusive on the point. 
He was superintendent of the plague hospital at Aboukir, in Egypt ; and as 
such, had the best opportunities of ascertaining that fact. Xor can any one 
of unprejudiced mind read the detailed account given by Sir Brook Faulkener, 
pl^sician to the forces in the plague at Malta, and entertain doubts upon the 
subject. — Vide the examinations of these officers. I would also refer to the 
works of Drs. Grohmann and Grassi, as the most recently published on this 
question, and which are reviewed in the 37th number of the " British and 
Foreign Medical Review." 



NATURE AND QUALITIES OF PLAGUE. 



57 



perfectly competent to give their unbiassed opinion ; and to 
these I may add my own experience on more occasions than 
one, as will appear in the course of this work. 

It is a very insufficient argument against the generally re- 
ceived opinion that the plague depends on contagion, that 
certain individuals may touch impested persons and things with 
impunity, or perhaps even be in close contact with them for a 
length of time, and yet escape unhurt. Such, indeed, were not 
uncommon occurrences during the period of this calamity 
when I was in Egypt. I was myself in intimate contact with 
my plague-patients for many days, and from the peculiar situa- 
tion in which I was then placed, found myself under the neces- 
sity of performing offices which, strictly speaking, did not belong 
to me ; yet I escaped unhurt ; whilst, at the same time, in 
the other pest-establishments in that country, several medical 
officers contracted the disorder, and three or more of them died 
of it. Now none of these officers were more exposed to its 
influence than I was, or more unpleasantly situated. 

In the plague of Lefchimo, Mr. Tory, hospital assistant, with 
Dr. Piccoli and his son, died of the disorder ; whilst Dr. De 
Georgio, who had the immediate medical charge of the patients, 
and lived for about six months in the midst of the plague-cases, 
day and night, never was attacked by it, but seemed quite in- 
vulnerable and insusceptible to its influence. It was my duty 
to visit the hospital and see this gentleman almost daily, and 
I confess I was often in dread of his having caught the malady 
Once in particular, he was so long in coming out to the barrie 
to speak with me, that I was apprehensive he had got it at last , 
which on every account would have been very painful for me, 
as in that case I must have sent in another medical officer to 
perform his duty, should he have been incapable of doing it. 

I think there can be no doubt that the ancient writers in 
medicine, as well as several of the general historians of anti- 
quity, were fully aware that the plague and some other diseases 
were of a contagious nature, for their works teem with observa- 
tions illustrative of that opinion. Amongst the former, I may 



58 



NATURE AND QUALITIES OF PLAGUE. 



mention that Galen expressly denominates the plague a con- 
tagious disease ; Areteus was so fully aware that the plague 
was contagious, that he drew a kind of parallel betwixt it 
and elephantiasis, thereby intimating that both were of a con- 
tagious nature ; Aristotle, the son of a physician, and a man so 
eminent in his day, was also of this opinion. I might mention 
other medical authors, but I conceive these to be sufficient for 
my purpose. 

Many are the testimonies which I might adduce from the 
general historians of antiquity to prove the point in question ; 
but as Dr. Yeats, in the " Quarterly Journal," No. 13, published 
in April, 1819, has entered so fully into the subject, I cannot, 
perhaps, do better than cite the authorities he mentions, to- 
gether with some of his judicious, and, in my opinion, conclu- 
sive remarks upon them : — 

" It will not (says he) be necessary to look into histories 
more early than that of Thucydides, although it is related that, 
after the destruction of Troy, a pestilential disease raged in 
Greece and the neighbouring countries of Asia ; and Herodotus 
attributes it to the miseries consequent to, and connected with, 
the Trojan war. 

" In the second year of the Peloponnesian war, which scourged 
Greece for twenty-seven years, and which commenced about 
four hundred years before the Christian era, a raging pestilence 
broke out in Athens. An invading army of sixty thousand men 
covered the beautiful plains of Attica, and compelled thousands 
of the inhabitants to seek protection within the walls of the 
already populous and crowded cities, thus generating and in- 
creasing, by a pollution of the air in confined habitations, pes- 
tilential disease,* &c. 

* I readily admit, that when great numbers of people are congregated to- 
gether, violent disease will break out, as happened at the celebrated siege of 
Jerusalem, under Titus, and as also occurred in other places, when great 
mortality ensued ; but I very much doubt whether the true plague will be 
generated thereby. 



NATURE AND QUALITIES OF PLAGUE. 



59 



" This pestilential disease raged chiefly at Athens, and also 
in other places, where the inhabitants were the most crowded. 
Diodoms Siculus, in his account of the same pestilence, declares 
the opinion that the disease arose in consequence of the unusual 
crowded state of Athens, &c. The Athenians not daring to meet 
the Peloponnesians in open battle on the plain, remained cooped up 
within their walls, and caused pestilential effluvia ; for great mul- 
titudes of people from all quarters congregating in the city, very 
readily generated disease by breathing a corrupted air. — Lib. 12, 
p. 101. 

" The eloquent and animated description which Thucydides 
gives of the symptoms clearly describes a fever of the most 
violent kind. It was attended with such violent thirst and evo- 
lution of animal heat, that the miserable sufferers threw them- 
selves into the sea, into ponds, and even into wells, to quench 
their thirst and raging heat. The art of the physicians not only 
was of no avail, but they themselves, and all who approached the 
sick, were cut off by contagion. Aax' oovrol i^aXi(rr<x 'iQvrxntov ouw xoci 
imolKktu 7rpo<rv£<rav. Such was the dread created by thus catching 
the contagion, that people were unwilling to attend the sick. 
There was a mutual fear of visiting each other, and whole 
families perished in consequence of want of assistance ; and 
they who braved the danger, from a principle of virtuous affec- 
tion in attending their sick friends, perished in heaps 

He adds, that the greatest part of the mortality was produced 
by the communication of the contagion. 

" In various parts of Diodorus's history we find accounts of 
pestilential diseases as they occurred in different parts of the 
world, particularly among multitudes of people collected to- 
gether for the purposes of war. A contagious pestilence broke 
out at Carthage at the time it was invaded by Dionysius, the 
tyrant of Syracuse. Diodoms, in his account of this pestilence, 
the symptoms of which he has described, particularly points 
out the infection and fatality produced by approaching the sick. 
As the mortality caused by the disease was great, and as the at- 



60 



NATURE AND QUALITIES OF PLAGUE. 



tendants upon the sick were cut off by it, no one dared to approach 
the infected, for all took the disease who had close communication 
with the sick ; so that, wretched indeed was the condition of those 
who were diseased, every one being unwilling to assist them ; for not 
only they who were not bound by any tie of relationship deserted 
each other, but brothers and friends were compelled to neglect their 
nearest relations and companions on account of their dread of the 
contagion. 

" In various parts of the history of the Romans by the 
Halicarnassian historian, we find accounts of pestilential fevers 
which spread havoc and destruction around ; and we not only 
can discover that these fevers were infectious, by the manner 
in which they spread, but Dionysius expressly tells us that they 
who touched or lived with persons so diseased became infected. 
In the four hundred and fifty-first year before the Christian 
era, and about three hundred after the building of the city, a 
contagious fever broke out in Rome. The most pestilenticd 
disease ever remembered brought destruction upon the city, by which 
almost all those affording assistance were cut off, and nearly one 
half of the other citizens were destroyed ; neither were the physicians 
able to attend effectually the sick, nor the friends and domestics to 
administer the necessaries ; for they who willingly attended others, 
by touching their diseased bodies, or dwelling with them, were seized 
with the same malady. 

" Here we have both contagion and infection clearly stated, 
the former communicated by touching the diseased bodies, the 
latter giving disease to those who came within the concentrated 
sphere of its action 

" Interspersed in various parts of Livy will be found histories 
of pestilential fevers, the infection of which, it is expressly 
stated, was spread by contact ; as in Lib. 3, c. 6 ; and Lib. 
25, c. 26. 

" In the sixth chapter of the fourteenth book of the history 
of Ammianus Marcellinus, where he describes the vices of the 
people of Rome, he alludes to a disease of a highly infec tious 



NATURE AND QUALITIES OF PLAGUE. 



61 



nature, at a period of time about three hundred and fifty-three 
years after the birth of our Saviour. It appears to be almost 
impossible to say what the disease was ; but it is sufficient to state 
that the account describes it to be so exceedingly infectious, 
that the servants sent to inquire after those who were ill, were 
ordered to undergo purification before they returned home." 

The author, after citing various apposite passages from 
Virgil, Lucretius, and Ovid, showing that the ancients were 
acquainted with the infectious nature of plague, concludes as 
follows : — 

" Instead, then, of having any doubts on the opinions of the 
ancients respecting the propagation of disease by contagion 
and infection, we have ample proof from the writings of their 
philosophers, physicians, and poets, not only of the existence 
of such an opinion, but of precautions taken to prevent the 
spreading of the infection." .... 

That Hippocrates and other ancient writers had not the 
same precise ideas respecting the terms contagion and infection 
that have been adopted by the moderns, is perhaps true ; but I 
think it can hardly be doubted, on reading attentively their 
works, that they considered many diseases to be catching, in 
the common acceptation of the word ; and with regard to the 
plague in particular, it is not, perhaps, to be wondered at if 
many of them were unable to decide positively whether it was 
propagated by actual contact with the sick alone, or through the 
medium of the atmosphere generally ; and, indeed, that question, 
as 'referable to this disease, has been a stumbling-block at a 
much later period among the moderns ; nor, perhaps, is it even 
at this day perfectly set at rest in the opinion of some. 

Although I am perfectly aware that among the ancient 
writers the word plague is used in a very indefinite sense, and 
although on different occasions it has been taken in a different 
acceptation by them, as there is reason to suppose that they 
designated by the term plague what were, strictly s])eaking, 
endemic and epidemic diseases, and those which are not unfre- 



62 



NATURE AND QUALITIES OF PLAGUE. 



quently attendant on armies, which we know are sometimes 
of a very malignant type, yet I am of opinion that enough can 
be collected from their writings to satisfy us that they knew 
well what the true plague was ; and we learn from these records 
the horror with which they viewed the invasion of this calamity. 
I grant that they were unable, in a satisfactory manner, to 
account for it ; and in the absence of a more philosophical 
reason, the anger of the gods was assigned as the cause. Hence, 
propitiatory sacrifices were had recourse to, in order to appease 
and satisfy offended heaven, and avert the scourge. Immense 
numbers were cut off by it ; and the disease, having exhausted 
itself by degrees, finally ceased, as happens in modern times 
in places visited by it. 

It is true that the ancients were unable, in a satisfactory 
manner, to account for its introduction ; for we find nothing 
in their works certain or conclusive on this point. But we 
know enough of this difficulty in modern times not to be at all 
surprised at this circumstance. On some occasions, we can no 
doubt explain distinctly the manner of its introduction, and 
even trace the road it has taken, from positive facts ; but, on 
others, there is so much obscurity attending the former, that 
we are greatly at a loss in this respect. Nor, when we consider 
the matter attentively, is this at all to be wondered at, if we 
reflect that its introduction is often owing to a secret violation 
of the laws of quarantine, unknown at the time, the punishment 
of which is death. This want, however, of proof on some occa- 
sions would be a very insufficient reason for supposing that in 
this country, at least, it owed its origin to local causes — that it 
sprung up indigenously, or that the opinions of ancient writers, 
as to its being an unavoidable calamity sent from Heaven, 
should be exclusively adopted.* 

From the clear descriptions of this disease given us at diffe- 

* Some sceptical persons considered the plague which made such havoc in 
London and other places in England in 1665-6, as simply an epidemic, and 
owing to local causes. 



NATURE AND QUALITIES OF PLAGUE, 



63 



rent periods by ancient writers, it cannot be doubted but that 
the invasion of plague among their contemporaries was not an 
unfrequent occurrence ; and in the leading character of the 
disease they confirm our more modern experience ; thus proving 
beyond contradiction that it is essentially the same disease at 
this day that it was in the earliest periods of which we have 
any records remaining. 

But although we do not find in the recorded plagues of anti- 
quity well-authenticated proofs of the precise manner in which 
it was introduced in any instance, yet we learn enough from 
the descriptions which writers have left us, that it was a cala- 
mity which travelled somehow from one place to another; 
and we are also informed that it was propagated by in- 
tercourse with the sick: and if there is any truth in the 
supposition that apparel and other things are capable of being- 
impregnated with the fomes of some diseases, — which, I presume, 
few will be found to deny, — it is not assuming too much to 
suppose that the fomes of plague is amongst the number ; and 
that it was propagated by that means, as well as by the sick 
themselves. 

There is in the plague records of antiquity an apparent defi- 
ciency of information respecting the spreading of the plague 
beyond the sphere or neighbourhood of a city afflicted by it, (for 
immediately in the vicinity of such place it is allowed that the 
disease did extend itself ;) which circumstance it may be neces- 
sary to explain here. In detailing the history of plague, the 
ancients, as I allow, were unable in a satisfactory manner to 
account for the precise manner of its introduction; yet they 
mention that a similar disease had occurred in other places some 
time before its appearance among themselves. In modern 
times, we are accustomed to trace from the most unquestionable 
proofs the progress of plague from place to place, almost without 
regard to distance, and after a considerable lapse of time. We 
know that the plague may be retained in certain articles for a 
very considerable period, and that the malady may be transported 



64 



NATURE AND QUALITIES OF PLAGUE. 



by such a medium to distant countries. The ancients seem to 
have been acquainted with this property which articles have of 
retaining in them for a length of time the fomes of the disease, 
and of its being propagated thereby; and I question much whether 
even a person coming from a remote place, where the plague 
was raging, was considered by them at all capable of bringing 
the malady amongst them, or whether any sort of precautionary 
measures were adopted with respect to him and his effects. I 
believe I am not hazarding too much in supposing that they 
were entirely ignorant of these matters, and consequently 
unable to give us clear and distinct information on this impor- 
tant point. They saw the calamity overwhelming a city and 
its neighbourhood ; they had heard that a similar calamity had 
raged in other places prior to its appearance amongst them ; 
but they were unacquainted with the true cause of the visitation, 
which we now attribute to intercourse with some impested place; 
and, for want of better reasons, they imputed it, as I have 
already mentioned, to offended Heaven, or to the pestiferous air 
being blown from a distance among them. Nor is there any- 
thing either preposterous or absurd in the supposition that 
formerly, as well as now, intercourse existed among nations by 
means of merchandise, emigrations, military marches, &c, by 
which the disease might have been, and no doubt was, propa- 
gated. 



CHAPTER II. 

The Jewish Legislator acquainted with contagion, and aware that disease was 
propagated thereby — In aggravated cases, Moses directs the garments to 
be burned, and the houses to be purified — Modern writers of the same 
opinion as to plague — Plague effluvia considered — How introduced into the 
system — Inoculating for the plague. 

I have thus endeavoured to prove from the records of antiquity, 
written by profane authors, that not only plague, but other 
diseases also, were disseminated by contagion, or, in other 



NATURE AND QUALITIES OF PLAGUE. 



65 



words, by intercourse with the sick ; and, that this was the 
opinion of several authors, whose integrity we are not accustomed 
to call in question. I will now for a moment turn to the page 
of sacred history, in which, although we find nothing very 
satisfactory respecting the true plague, we have enough to 
demonstrate the belief in the doctrine of contagion. 

No one can well doubt, on reading the book of Leviticus, 
that the Jewish Legislator, in his orders and directions to the 
children of Israel, was perfectly acquainted with the propagation 
of certain diseases by contagion ; for not only does that 
opinion pervade his instructions to them, but he issues express 
orders to that people, with the view of preventing the contagion 
from spreading among them. Thus the 13th chapter of that 
book is very explanatory of the appearances of the leprosy; 
and he there gives explicit orders for the separation of the 
lepers from the rest of the community; also, that their garments 
should be well purified, and in the more aggravated cases, he 
clearly directs that the clothes should be burned ; conceiving, no 
doubt, that in the more virulent cases, it was extremely difficult 
to get rid of the contagious matter, and that it would be better at 
once to destroy them than to run any risk of using them again. 
In verse 46th of that chapter he says : " All the days wherein the 
plague (viz., the leprosy) shall be in him, he shall be defiled. He is 
unclean. He shall dwell alone; without the camp shall his habita- 
tion be." 

From the 47th verse to the end of the same chapter, directions 
are given respecting the garments of the lepers ; and in the 
52nd verse, alluding to very aggravated cases, or what he terms 
a fretting leprosy, he says : " He (the priest) shall burn that 
garment, whether warp or woof, in woollen or in linen, or anything of 
skin, wherein the 'plague is, for it is a fretting leprosy ; it shall be 
burned in the fire." 

In the following chapter, Moses is also very explicit in his 
orders to those who have been cured of the disease, to wash 
and purify themselves. Verse 8th — " And he that is to be 



66 



NATURE AND QUALITIES OF PLAGUE. 



cleansed shall wash his clothes, and shave off all his hair, and 
wash himself in water, that he may he clean ; and, after that, he 
shall come into the camp, and shall tarry abroad out of his tent seven 
days? 

Nor did his precautionary measures extend only towards the 
preventing of the spreading of this disease by the sick and their 
clothes, but also to the houses of those who were affected with 
that malady ; for in this chapter we find a long account of the 
manner of purifying those houses, and he gives particular 
directions that they should be emptied before the priest went in 
to see them. 

I have adduced these passages to show that the doctrine 
of contagion was understood by the ancients, confirming the 
fact, not only by the testimony of profane writers, but also 
by what is recorded in the sacred scriptures ; and with such 
convincing proofs before us, I cannot well conceive how any 
one can be so sceptical as to have any doubts upon the 
subject. 

The remark I made relative to the indefinite acceptation of 
the term plague among the profane authors seems to be equally 
applicable to some parts of the writings of the sacred historian ; 
for in the 13th chapter of Leviticus, from which I have quoted, 
this disease, — viz., leprosy, — concerning which Moses is enact- 
ing laws, is denominated in different parts of that chapter "the 
plague of leprosy" 

In the sacred writings, mention is also made of a sudden and 
destructive pestilence, with which it pleased the Almighty to 
afflict the Jews, as a punishment of King David for his vanity 
in numbering the people of Israel, and which in the space of 
three days destroyed 70,000 souls. See 24th chapter of Second 
Book of Samuel. This appears to have been rather a signal 
manifestation of the Divine power than the true plague ; and, 
indeed, in no part of the sacred writings do we find a satisfactory 
account of that disease, although, from the term plague, which 



NATURE AND QUALITIES OF PLAGUE. 



67 



frequently occurs in them, it is evident that such disease was 
known to the sacred historians. 

The modern authors who have written on plague, and who 
considered it as a disease depending on contagion, are so 
numerous, that it is unnecessary even to mention all their names 
here. It would, however, be improper to pass by the name of 
Dr. Russell, a physician eminently qualified, from his deep 
research and extensive opportunities, to give his opinion on 
this important subject. He, in his excellent and elaborate 
work on Plague, is fully convinced of its being a disease con- 
tracted by contagion alone, and gives the most convincing- 
proofs of its being so. 

Dr. De Mertins, in his account of the plague which raged in 
Moscow, in 1771, is of the same opinion ; and he is equally 
conclusive with regard to the facts, which he details, of that 
plague in the support of this view. 

The British medical officers who served in Egypt, and were 
employed in investigating this disease, were almost without 
exception convinced of its contagious nature ; and to all this 
weighty mass of evidence may be added our late experience in 
Malta, in the Ionian islands, and in the plague which appeared 
at Noya, in the kingdom of Naples. In all these places was the 
plague not only proved to be depending on contagion alone, 
but in all these instances it was suddenly arrested and finally 
extinguished by acting on that principle. 

That there are, however, some few^ possessing high profes- 
sional acquirements, who entertain a different opinion with 
respect to plague is not to be denied ; yet I trust that, at some 
future day, from an unprejudiced investigation of this important 
subject, and such additional facts as experience may afford, 
they may be induced to alter their opinion. But I should regret 
exceedingly that any opinion respecting the non-contagious 
nature of plague should ever induce the Government of this 
country (or indeed of any other) to act upon it, thus breaking 



68 



NATURE AND QUALITIES OF PLAGUE. 



down the barriers of our self-preservation, and thereby laying 
us open to this dreadful malady. 

That the matter of plague, whatever it may be, is highly con- 
tagious and subtle is beyond all doubt. Ancient writings as 
well as modern experience prove it to be so. But what its pre- 
cise nature is, — whether a vapour or depending on animalcules, — 
I will leave to others to elucidate who may be fond of such 
discussions. Nor are we better informed of the precise period 
when it first made its appearance among mankind ; yet it must 
have been of very ancient date ; the earliest records extant, 
both sacred and profane, mention it. 

It is perhaps difficult to say with precision, beyond what is 
known to occur from touching impested persons or things, how 
the effluvia of plague contaminates the system. My own opi- 
nion is, that this happens by absorption through the skin, from 
actual contact, or near approximation, which I consider as 
merely a modification of touch. Nor do I think it of any mate- 
rial consequence what part of the body is exposed to the im- 
pested object. Most commonly, for very obvious reasons, it is 
supposed to be introduced by the hands ; yet I should conceive 
that, even without actual contact, we cannot with spufety approach 
close to a person ill of plague, lean over him, and inhale the 
vapour arising from his body, as the medical practitioner does 
in his ordinary practice. This would, I think, be running too 
great a risk. Indeed, several writers on this subject warn as 
against approaching within a certain distance of persons ill of 
plague ; and some have attempted even to define that distance, 
which they say should not be nearer than three feet. On this 
particular point I have nothing to say from personal experi- 
ence, for I have been often in contact with my patients, and yet 
have escaped unhurt. Nor can I take it upon myself, from any- 
thing that has come under my own particular notice, to say how 
near one may approach with impunity; I, however, should think 
that to approach nearer than three feet would be running some 
risk, which may as well be avoided. I of course except those 



NATURE AND QUALITIES OF PLAGUE. 



69 



whose duty it is to be in close attendance on the sick ; they 
must necessarily be always more or less in contact with them ; 
indeed, this is a distressing duty, but one which must be 
performed. 

Another mode of introducing the plague into the system, which, 
by way of experiment, has been resorted to, is by inoculation, or 
inserting the plague virus into the skin ; and I have no doubt but 
this is as effectual a way as any other of contracting the disease. 
But inoculation can never be resorted to as a measure of pre- 
caution, such as is practised in the small-pox or the vaccine 
disease, since it is found not to mitigate the disorder; and I 
am not aware that any one, having inoculated himself, and 
had the disease, ever recovered from it ; so that I should think 
that none but the foolhardy will attempt it again, seeing how 
ineffectual it is in diminishing or modifying the violence of the 
disease.* 

In Egypt, Dr. Whyte inoculated himself with virus from a 
bubo, and died of plague ; and I have heard, or read, some- 
where, that Des Genettes, Physician-General to the French 
army, inoculated himself; but having very soon afterwards 
washed the part, it did not take effect, as I presume it had not 
sufficient time to enter the system. It is generally believed, too, 
that Buonaparte also inoculated himself, washed the part im- 
mediately afterwards, and thus escaped. These two cases of 
exemption after inoculation speak for themselves, and require 
no comment. Political reasons induced these two distinguished 
men to act thus, as it was well-known that at that period a 
great dread of plague prevailed in the French army, and it be- 
came necessary to fortify the mind of the soldiery against it by 
making light of it by this deception. 

* It is a generally received opinion, founded on observation, that persons 
who have once passed through the disease do not die from a second attack ; at 
least, not in the same season. We had several instances of second attacks in 
Corfu, but they all terminated favourably at length, although these persons 
suffered a good deal from glandular derangement and ill health, after every 
plague symptom had disappeared. 

G 



70 



NATURE AND QUALITIES OF PLAGUE. 



Dr. Whyte's case was unfortunately one which showed the 
danger of inoculation, but the other two I have recited were 
not. Other cases have been mentioned in which inoculation is 
said to have failed, but I suspect, generally speaking, were 
owing to the same cause — i.e., washing the part before the 
virus had time to enter the circulation. 



PART IT. 



ON THE ORIGIN & HISTORY OF THE PLAGUE, WITH 
AN ACCOUNT OF ITS SYMPTOMS AND PROGNOSIS. 

CHAPTER I. 

Egypt supposed the focus of plague — The diffusion of plague ascribed to pre- 
ternatural phenomena, meteors, earthquakes, hurricanes, &c. — Plague an 
imported disease — It excited much attention about the time of the Crusades 
— Precautionary measures adopted against it about the same period — How 
quarantine laws came to be established, and gradually perfected — The 
exemption of Europe ascribed to these laws — Dreadful effects of fatalism 
among the Mahometans — Differently evinced among them and Christians — 
Fatalism on the decline in Turkey — The malady capable of being dimi- 
nished, if not entirely expelled from plague countries— for instance, from 
Turkey in Europe, — unless owing to local causes, which cannot be removed 
or controlled — Doubts whether or not the plague is indigenous in Turkey 
in Europe — Policy of the Ottoman Porte with respect to plague — Quaran- 
tine laws, if successful in expelling the plague from civilized Europe, 
why should they not be so in expelling it from Turkey in Europe — Plague 
continuous there — Introduction of plague into civilized Europe attri- 
buted to imported contagion. 

The real origin of plague is, I believe, to this hour enveloped 
in impenetrable mystery ; and although many attempts have at 
various periods been made to draw aside the veil that covers it, 
I question much whether any of them have been hitherto satis- 
factory, or even plausible ; nor can I attempt to elucidate this 
obscure point. 

Yet it is a curious fact that Egypt and the confines of Ethio- 
pia have, almost' by universal consent, been stigmatized as the 
focus from which this calamity has issued from time to time, and 

ci 2 



7*2 ORIGIN AND HISTORY OF THE PLAGUE ; 

which has from time immemorial caused such terror and conster- 
nation, together with such singular destruction of the human 
race, in almost every part of the habitable world. The cause of 
this malady in those countries has been said to depend on 
putrid animal effluvia from the putrefaction of immense myriads 
of locusts which contaminate the air ; and which, it is said, have 
sometimes appeared in such incalculable numbers as to darken 
the face of the sky, and even almost destroy the whole vegetable 
creation in those regions ; after which, having nothing left to 
feed upon, they die ; and in their death, are productive of no 
less misery to mankind than they were whilst alive. The heat 
of the climate, aided by a particular state of the weather, is sup- 
posed to occasion in the immensely congregated heaps a high 
degree of putrefaction, which tainting the air with a most 
noxious effluvia,w2LS considered by the ancients capable of pro- 
ducing this disease. The Nile, also, has come in for its share 
of blame, and has been considered as an active agent in pro- 
ducing plague by the retiring of its waters. 

In the superstitious and dark ages of antiquity, the assist- 
ance of preternatural phenomena was called in to aid their 
speculative opinions in accounting for this singular and appal- 
ling calamity. Meteors, earthquakes, and hurricanes were 
supposed to be its attendant satellites, and to have carried it 
through the air for the destruction of mankind ; and, I may 
add, that some of the more modern authors, equally unable to 
account for its introduction into particular places, and unac- 
quainted with its true character, have adopted these opinions, 
but, I apprehend, with no better result. 

Whether those causes, either separately or conjointly, have 
been the true cause of the plagues which have emanated from 
Egypt and the confines of that country, and whether all, or 
some of them still exist, and are capable of generating this dis- 
ease, (supposing for a time that plague in all its ramifications had 
become quite extinct there,) is a question I am unable to answer. 
T will therefore leave it to those who may be more competent to 



ITS SYMPTOMS AND PROGNOSIS. 



73 



investigate the point. Yet, I believe it has been ascertained that 
immense swarms of locusts have at times appeared in places 
bordering on the Caspian Sea, in Tartary, and in other places, 
where they were very destructive to vegetation of every kind, and 
consequently productive of attendant misery, but still without 
generating or bringing into existence the malady in question. 

Leaving, therefore, the origin or cause of plague in all its 
pristine obscurity, let us consider it as a disease imported from 
countries where, in a greater or less degree, it is known always 
to exist. 

There can be no doubt, I think, that the plague appeared in 
Europe before the time of the Crusades, although that epoch 
has been considered by some as the period of its earliest intro- 
duction into this quarter of the globe. But the fact is, that 
everything connected with the Crusades excited such general 
interest throughout Europe, that, on the return of the Crusaders 
from the Holy Land, bringing the disease with them, it fixed 
unusual attention from the great mortality which it then caused 
in several parts of Europe ; and from the lapse of time, during 
which little was recorded concerning it, which was clear and 
satisfactory prior to that epoch, it was considered in some 
degree a new disease, and as such, as I have just noticed, 
excited in an unusual degree the public attention. That, how- 
ever, it was no new disease, but a fresh importation at that 
period, we require no other authority than that of Procopius, 
who speaks of it and describes it as a malady that had over- 
whelmed Europe during the reign of the Emperor Justinian. 
Other proofs might be adduced in support of this opinion, but 
this I conceive to be sufficient. 

We have shown by quotation from the sacred writings that 
the propagation at least of some diseases by contagion was 
known to the Jewish Legislator, who enacted measures to pre- 
vent the spreading of such. We have likewise shown that pro- 
fane writers were aware that other diseases, as well as the 
plague, were propagated by intercourse with the sick ; but that 



74 ORIGIN AND HISTORY OF THE PLAGUE ; 

they were not fully acquainted with the extent to which this 
propagation was carried. Indeed, I do not recollect ever having 
read that, in any plague mentioned by them, its invasion into 
any place was strictly attributed either to persons or things 
imported from countries where the calamity was raging ; and I 
apprehend that they were by no means well acquainted with that 
fact, although it is not to be denied that Moses, even at this 
early period, commanded precautionary measures to be earned 
into effect among the Jews. 

The plague, therefore, having excited such universal interest 
about the time of the Crusades, a new epoch in the history of 
that disease commenced, and people began to find that by 
keeping themselves separate from the sick they escaped the 
malady, whilst those who continued their usual free intercourse 
with them, were attacked by it, and suffered in a much greater 
degree than they who kept themselves apart and secluded. I 
do not here suppose that their seclusion was always absolutely 
perfect ; for it is not to be imagined that they then thoroughly 
understood the principle, or acted upon it to the full extent. 
Yet I imagine they saw enough of the advantages accruing from 
it on some occasions to rivet their attention, and impress on 
their minds the necessity of adopting that plan, and thus taking- 
some steps towards their own preservation. 

As the means of self-preservation in the time of plague came 
to be better understood in countries where it had frequently 
made its appearance, people began to reflect more on the 
subject. They saw, as I have just observed, that by avoiding 
the sick, or rather by not mixing promiscuously with them, as 
heretofore, many escaped the disease ; and building on that 
fact, they advanced a step further, concluding that, if by sepa- 
ration they were exempted from the plague, so by avoiding 
altogether any intercourse with places where they knew the 
malady was raging, they might thus prevent the introduction of 
the disease amongst them. Thus, something in the shape of 
quarantine establishments began to be formed, not only to 



ITS SYMPTOMS AND PROGNOSIS. 



75 



prevent intercourse with places where they knew the plague to 
be raging at the time, but also to prevent free intercourse for 
some time after it was said to have subsided. 

It is not reasonable to expect that establishments of this kind 
could at once approach perfection ; and doubtless the system 
had many opponents ; yet as in those places where the strictest 
rules were kept up, the advantages of such a system became 
manifest, that system was by degrees better understood, and 
ended at last in the adoption of a regular code of laws, known 
by the name of the laws of quarantine. 

Although the general system of prevention was now pretty well 
understood and acted upon, yet every state did not adopt pre- 
cisely the same regulations ; but, on the contrary, some differed 
materially in this respect from others. It required time and expe- 
rience to consolidate these laws ; and, as men became more en- 
lightened, and the subject was more studied and supported by 
facts, so these laws became more perfect and intelligible ; by 
which means some of the laws, which were loose and incon- 
sistent, by being modified, acquired new force and stability ; 
whilst the whole became amalgamated and systematically ar- 
ranged, as we see at the present day.* 

It is to the active operation of these laws that we are to at^ 
tribute the general exemption of Europe from plague ; and to 
the violation of them, either directly or indirectly, that its in- 
troduction takes place amongst us : and these facts I conceive 
to be so clearly ascertained, that it would be but a waste of time 
to employ any arguments in support of them ; for although our 
mode of living, our manners and customs, may have been 
altered, and even a change of the climates may have taken place, 

* The first code of Quarantine Laws established in Europe, which seems to 
have been arranged on scientific principles, was that of Venice, by order of 
the Senate, in the year 1448 ; which was framed for the express purpose of 
preventing the extension of the malady by contact of persons in health with 
persons labouring under the disease, " per impedire il progredimento della con- 
tagione de uu individuo malato ad un sano." This was done after that city had 
suffered very severely from an invasion of the disease. 



76 ORIGIN AND HISTORY OF THE PLAGUE; 

yet they are certainly not so entirely changed and essentially 
altered in every respect, as to prevent the germs of the disease 
from springing up occasionally, did they permanently exist, 
unconnected with the principle of imported contagion, in any 
country in civilized Europe. Nor can we suppose for a 
moment that the peculiarity of climate in any country of Europe, 
or that any other causes with which we are acquainted, would 
prevent the disease from running its usual course, if left to 
itself, were it to spring up there ; knowing, as we do, the de- 
vastation it has made wherever it has been imported, until 
checked by the proper remedies ; which devastation, I believe, 
has been as fatal in some parts of Europe as ever it has been in 
Turkey itself. 

The vulgar belief that the plague is a dreadful scourge sent 
from Heaven, in which all human efforts are useless and un- 
availing, has slain its millions, and often rendered nugatory the 
means that were adopted to limit its ravages : and to this un- 
happy circumstance among the disciples of Mahomet is owing 
the singular apathy and indifference which are to this day exhibited 
amongst them with respect to this malady ; for they not only 
hold it useless, but even criminal and impious, to interfere or to 
use any means towards arresting its progress, or putting a stop 
to its ravages ; and whilst that prejudice still continues amongst 
them, there is no wonder that we hear of the tremendous havoc 
the disorder makes, and the length of time it continues to exist. 
If I am rightly informed, the plague which is now raging along 
the shores of Barbary, has existed upwards of two years without 
intermission, and still continues to extend itself, with different 
degrees of violence, according to circumstances. 

Another misfortune attending this belief in fatalism, and 
which, I may say, is peculiar to Europeans, is, that when over- 
whelmed by the disease, they become maddened by despair, 
and, throwing off all restraint, give themselves up to a licen- 
tiousness and depravity at which human nature revolts ; as oc- 
curred in the celebrated plague of Messina ; in that of Mar- 



ITS SYMPTOMS AND PROGNOSIS. 



77 



seilles, in 1721 ; and, to a certain extent, in Moscow, in 1771. 
In this latter city, these excesses were put a stop to by the in- 
terference of the military, but not before the seeds of the disease 
Avere spread far and wide, as was lamentably proved by the 
increased mortality which took place soon after that dismal 
event. 

This doctrine, however, of predestination is not now uni- 
versally adopted even among the Turks themselves; for the 
more enlightened of them, seeing that the disease is so fatal to 
them, and that the- Franks escape, comparatively speaking, with 
impunity by shutting up, begin now to open their eyes to the 
propriety of using precautionary measures, and with good 
effect. I have been told that Ali Pacha of Albania — a Greek 
by birth, but in religion and habits decidedly a Turk — has more 
than once had recourse to measures of restraint, to prevent the 
extension of the mischief, and has been successful. The Vizier 
of Grand Cairo, too, if report speaks true, has lately carried into 
effect the same system. Other instances in point might be ad- 
duced if necessary.* 

Could the followers of Mahomet be prevailed upon to put in 
execution the same vigorous and decisive measures for arresting 
the career, and finally eradicating the malady in the countries 
possessed by them, which for such a length of time have been 
adopted in Europe, with such evident advantage to mankind, 
I think it is not presuming too much to suppose that similar 
results would follow there ; and even if they were not in the 

* This was written when Mehemid Ali was only Grand- Vizier of Egypt, 
a man of enlarged and comprehensive mind, whose name and exploits have 
since that time become celebrated over Europe. At that time, his active and 
discriminating mind saw the necessity of adopting some quarantine regulations, 
which were put in force, although it is not likely that they were very perfect. 

I have been informed by Sir Gardener Wilkinson, who has resided several 
years in Egypt, and has given much valuable information to the public re- 
specting that country, that Mehemid still zealously maintains restrictive mea- 
sures in his dominions, being perfectly aware of the advantage of doing so both 
to commerce and the general health. I am, however, not fully informed of the 
precise regulations which he has thought proper to enact. 



78 



ORIGIN AND HISTORY OF THE PLAGUE; 



first instance to carry thein into the same rigorous effect, 
which is done in some places, they would find certain benefits 
arise, were it but partially adopting them, which in the end 
would lead to their general use on the same principles as are 
now earned into effect amongst Europeans. 

This is, however, supposing that the disease does not originate 
in Turkey in Europe, and is not indigenous there, but imported 
into that country from some other place, which it is said fre- 
quently to be. 

But if this disease originates in Egypt, owing its annual ap- 
pearance, in one place or other there, to local causes, and is 
thence diffused by intercourse into other parts of the Turkish 
empire, — an hypothesis which I cannot take upon myself either 
to confirm or refute, — -then it follows that any precautionary mea- 
sures in Egypt itself must be perfectly unavailing for its total 
extinction ; and all that could be done, after having once driven 
the malady out of the rest of the Turkish dominions, is to put 
in force the same means with regard to Egypt that have 
banished it from the rest of Europe. 

But if, as some imagine, the disease is indigenous in Turkey 
in Europe, and owes its origin to local causes incapable of 
being controlled by human power, which, until clearly proved 
to me, I can never believe, then it is also obvious that any 
mode of expelling it thence must be equally unsuccessful. 

It is needless here, and indeed it is at the best but very un- 
satisfactory, and extremely doubtful, to enumerate the various 
local causes which have been assigned by travellers and writers 
as capable of producing the plague in Turkey, as well as in 
other places. They are merely suppositions, unsupported by 
proofs ; and although such may, and no doubt do, produce cer- 
tain diseases, yet I conceive them to be incapable of generating 
the disease in question. 

It is, perhaps, the policy of the Ottoman government not 
only to keep alive the belief of its endemic nature, but to use it 



ITS SYMPTOMS AND PROGNOSIS. 



79 



as an arm of defence against the European powers ; and it is, I 
believe, not to be doubted but the treasury of the Sublime Porte 
is often benefited by the ravages of the plague. It is therefore 
not to be expected that any effectual means, in the present 
state of things, will be taken by that government to exterminate 
the malady. Should it happen, however, when, in the course 
of time, some nations fall and others rise up, and become for- 
midable, that this government should be subverted, and replaced 
by a liberal and enlightened administration, adopting and 
putting into effect the same views with regard to plague which 
have been successful in expelling it from civilized Europe, I 
will venture to predict that the results will be the same. At all 
events, the hypothesis which I have formed on the subject will 
be put to the test, and time will show how far it is well 
founded. 

If in the extensive countries comprehended in civilized 
Europe, and in a great part of the rest of this quarter of the 
globe, which may still be considered, if not actually in a state 
of barbarism, at least approaching it, where there is almost 
every variety of climate, the extremes of heat and cold, various 
usages, manners, and differences in the modes of life, together 
with an endless variety in point of local situations, the plague 
has been expelled from them for centuries past, there can be 
little doubt, I think, (always supposing that it does not originate 
there,) but that it may also be excluded from Turkey in Europe ; 
for until it is proved to my satisfaction that the invasions of 
plague, with which the various parts of Europe, exclusive of 
Turkey, have been visited, have originated where they first ap- 
peared, I hold every such invasion to have been produced by 
the seeds of the disease being imported from some other place ; 
and this fact has been so clearly established in such a variety 
of instances for some centuries past, as well as on several recent 
occasions, — viz., in Malta, Corfu, Noya, and Ccphalonia, — that 
we can have no good reason for refusing to adopt this opinion ; 



80 ORIGIN AND HISTORY OF THE PLAGUE j 

and although some centuries past, when this subject was not so 
well understood as it is at present, when there was so much cre- 
dulity, and so many superstitious inferences afloat respecting 
this disease, some doubts of its being an imported one may 
have arisen, yet the more recent instances which I have quoted 
throw aside those former doubts. They are so well authenti- 
cated, and have been so satisfactorily traced from their first in- 
troduction till their final eradication, that there appears to be 
no room whatever for doubt on the matter. 

I am certainly induced to question the opinion which some 
have adopted, that this disease originates in Turkey in Europe ; 
although there is not the least doubt but that it is always in a 
state of greater or less activity in some places there, in conse- 
quence of the intercourse betwixt places, and a total disregard 
to the measures of prevention and of subsequent purification 
after the disease has subsided. To me it appears that, with 
regard to Turkey in Europe at least, the disease does not origi- 
nate annually, or even in two or three years, or, indeed, at any 
stated time, from local causes ; but that it is there a continuous 
disease, kept up from time to time by the semina being never 
thoroughly destroyed, through neglecting the means of subse- 
quent expurgation after the disease has ceased ; for it is this 
complete and perfect expurgation of every thing, person, and 
place that may retain the matter of plague, which alone can se- 
cure us from a subsequent attack : but if this is attended to, we 
have no reason to dread the return of the disorder, except from 
a fresh introduction or importation. Thus it is that the malady 
is constantly kept alive in those countries, and appears from 
time to time there. Thus^ in my opinion, it is propagated, from 
place to place, by intercourse with infected places, and in a 
particular manner has attended the followers of Mahomet in all 
their movements, both commercial and military. 

From what I have said, it will be seen that I attribute the 
various invasions of plague into civilized Europe to importation 



ITS SYMPTOMS AND PROGNOSIS. 



81 



from places where it was either raging at the time, or had ex- 
isted some time before, by means of persons or effects con- 
taminated with matter of plague, and not to any inherent or 
specific causes existing in this quarter of the globe. This I 
consider not only as an established fact with regard to a large 
portion of Europe, at least, but also as a matter for self-con- 
gratulation ; for I think nothing can be so appalling as the idea 
that this dreadful calamity may spring up indigenously even in 
England, and that we are liable, from a combination of the 
alleged causes, unconnected with importation, to be visited by 
this destructive disease. Yet this opinion has its advocates at 
the present day. 

On what other principle are we to account for the long ex- 
emption from plague which some places have experienced ? Is 
it not reasonable to suppose that in the course of a century the 
causes which are alleged to be capable of producing the 
plague must have occurred and produced the disease again ? 
But is this clearly ascertained to have ever occurred, without 
reference to the possibility, nay, probability, and in recent cases 
positive proofs, of its having been imported from another 
place ? 

In the more recent plagues, it is proved beyond contradiction 
that the places in which it broke out enjoyed their usual health 
until the seeds of the malady were imported. Even the dates 
of this importation have in some instances been fully proved ; 
and from these periods this calamity (indeed, with reference to 
other common diseases, I may designate it this new disease,) ap- 
peared, and ran its usual course until effectual means were 
taken to put a stop to it ; and that, these being put in exe- 
cution, it disappeared altogether in a short time ; in fact, was 
completely destroyed root and branch ; after which the people 
enjoyed their usual state of health. 

In England we know that there has been no plague since 
106G. When in Corfu, I learned that there has been none in 



82 



ORIGIN AND HISTORY OF THE PLAGUE ; 



that island for above a century. In Malta, they had none since 
1743 (when a monument was erected to the then Grand Master 
for having arrested it) until the year 1813. In France there 
has been no plague, beyond the precinct of a lazaretto, since 
the well-known plague of Marseilles in 1721 ; and other 
countries have experienced a still longer immunity. 



CHAPTER II. 



Plague imported by sea — Shown to be an imported disease by its being sup- 
pressed in lazarettos — Plague also imported by land — Generally accom- 
panying the Mahometan armies — Thus traced to Jassy, Moscow, &c. 

It is a curious fact, and one from which much is to be deduced, 
that the plague generally appears first in a place near the sea, 
and in places adjoining those countries where it is usually pre- 
valent. This circumstance, which is not to be doubted, is in 
my mind an additional proof that the plague is an imported 
disease. The fact is as I have stated, yet I do not consider it 
as quite conclusive on that point ; for we know enough of the 
plague, and of the facility with which it may, by being closely 
shut up, be transported to places at a great distance from the 
sea, to doubt its being carried into the very interior of any 
country, and that it will first appear there, where the things 
which contain the contagion are exposed, supposing that the 
disease is not in the constitution or the clothes of the persons 
engaged in transporting them thither : and this, I am fully per- 
suaded, is not only quite possible, but has actually been the 
case, and probably is the cause why the plague has been con- 
sidered as springing up indigenously. 

But we have the most convincing proofs that the plague is an 
imported disease, from the well established fact of its having 
been brought into several lazarettos ; and there, by the ap- 
plication of the proper remedies, arrested in limine; showing not 



ITS SYMPTOMS AND PROGNOSIS. 



83 



only, in the clearest manner, that the true plague was actually 
imported into them, but also that, by being confined, it did no 
mischief beyond the walls of the lazaretto where it was landed. 
This fact also proves another important circumstance, the ab- 
surdity of the opinion that the air becomes contaminated with the 
plague contagion, and hence is capable of extending the malady 
by assimilating with and poisoning the mass of atmospheric air. 
For if, as some have hypothetically imagined, one plague patient 
is capable of contaminating the air to an incalculable extent, 
how does it happen that it has been brought into lazarettos, and 
fairly extinguished there, almost without its being generally 
known that it had been introduced into them, and without doing 
any harm beyond those well-regulated establishments, as ap- 
pears to have been the case in Leghorn, Venice, and other 
places? When at Leghorn, with the British army, in 1814, I 
was informed by the late Mr. Polhill, surgeon to the factory 
there, that the plague had been frequently brought thither to the 
lazaretto, and was speedily extinguished by the adoption of the 
proper remedies ; and that it did no further mischief is clearly 
seen in the fact, that if left to itself, or if it had not been 
speedily suppressed, it would soon have spread death and con- 
sternation in every direction, which could not have been con- 
cealed. I was not informed of the particular detail of these 
cases, which occurred either in Leghorn or in Venice, but merely 
told, as a matter of fact, that the plague had actually appeared 
in them more than once, and had been suppressed there.* 

* I have since seen Dr. Granville's admirable letter to the Right Honourable 
Mr. Robinson, president of the Board of Trade, in which allusion is made to 
plague having been imported into the lazaretto of Leghorn. He there says in a 
note to that letter, page 99, Fodera and Nacquart both state that the officers of 
health at Marseilles, Leghorn, and Toulon assured them that cases of plague broke 
out occasionally in the lazarettos of those towns, after the arrival of vessels from 
the Levant ; and that the disease is extinguished immediately by vigilant segre- 
gation. — Traite de Medecine Legale, 1808 ; and Dictionnaire des 
Sciences Medicales, 1810. General Spanocchi, Governor of Leghorn in 
1814, assured me that two cases of plague had shortly before occurred in that 
lazaretto. 



84 



ORIGIN AND HISTORY OF THE PLAGUE, 



Thus it is proved that the plague is imported by sea; and 
the consequence is, that it first appears, for very obvious reasons, 
in places adjoining the sea-shore. Let us now view it as im- 
ported by land from plague countries, and the conclusion will 
be the same. 

It would be superfluous to state the various occasions on 
which the plague has been introduced into the provinces bor- 
dering on Turkey, from the movements of the Mahometan 
armies, which were almost always accompanied by this disease, 
and were often as fatal to their antagonists as the sword 
or the cannon, at times almost desolating the countries that 
happened to become the theatre of their warlike operations; 
for no nation has ever been long engaged in war with them 
without having been attacked by the plague. Hungary, Poland, 
and Russia have all had reason, for a long period after, to re- 
member the ravages of this frightful calamity thus introduced 
among them, and which ultimately led to the creation of rigid 
quarantine establishments on their frontiers, which establish- 
ments have proved eminently successful in the time of peace, as 
well as conducive to their security when they were actually en- 
gaged in war with the Turks. Spain and Portugal, too, during 
the time these countries were occupied by the Moors, frequently 
suffered from the invasions of plague. I understand that the 
sanatory regulations adopted by the government of Austria 
throughout their empire are remarkably well arranged, and 
conducted with scrupulous exactness. 

The plague which desolated Moscow, and other parts of the 
Russian empire, in 1771, was ascertained to have been carried 
into Jassy by the Turkish army ; and soon after, the troops in 
that city became impested. It was not at first generally known 
to have been the plague, but supposed to be a fever of a very 
malignant nature, although some of the most eminent physicians 
pronounced at once the malady prevailing there to be the plague. 
From thence it was carried by the soldiers going from Jassy to 



ITS SYMPTOMS AND PROGNOSIS. 



85 



Moscow, where it first appeared in the military hospital. The 
city soon became overwhelmed by it, and from thence it after- 
wards spread into other parts of the empire. 



CHAPTER III. 

The Franks escape by shutting up — Plague most destructive in crowded 
places, and among the attendants on the sick — The Foundling Hospital in 
Moscow preserved by the jealous care of De Mertins, in keeping it insu- 
lated — Danger of permitting intercourse with, and of receiving strangers 
in the time of plague. 

I am, as I have all along declared, most fully persuaded that 
the plague is only communicable by contact, and propagated by 
intercourse with impested persons and goods ; else, why should 
those escape who studiously avoid all intercourse with either by 
shutting themselves up, as the Franks invariably do, when once 
the malady is ascertained to have commenced its ravages ? For 
it is a well known fact that in plague countries, on the alarm 
being given of the plague breaking out, and when its existence 
is positively ascertained, they begin to shut themselves up in 
their houses, and remain in strict quarantine until they conceive 
the danger to be over, and by this seclusion, they, generally 
speaking, escape the disease. Nor is it any argument to the 
contrary that even some of them become attacked, as they 
have, in some way or other, from the non-observance of strict 
quarantine, become exposed to it, or have gone abroad too soon ; 
for the desultory cases which occasionally appear amongst 
them I impute entirely to these causes. I admit that it may 
sometimes be difficult to know how they got the disease amongst 
them, because no one will confess himself guilty of an open or 
secret violation of the laws of quarantine. Besides, a breach of 
them may happen from ignorance, inattention, or the obstinacy 

H 



ORIGIN AND HISTORY OF THE PLAGUE ; 



of their servants, which it is difficult or impossible at the time 
to ascertain. But in either case, the consequences are the same 
in the introduction of the disease. 

Yet, even with these exceptions, the fact is clearly proved 
that those do escape who shut themselves up, and avoid all in- 
tercourse, whilst the disease is making considerable havoc 
among their neighbours without. 

To suppose, therefore, that they would voluntarily seclude 
themselves from all society, beyond their own immediate 
families, and endure all the vexatious privations, confinement, 
and a certain loss of property, if they are engaged in commerce, 
as almost all the Franks are, and being thus necessarily pre- 
vented from looking after their own affairs, and following their 
usual pursuits, without a firm persuasion that by so doing they 
would escape the malady which is making such frightful havoc 
among their less careful neighbours, is opposed to all the rules 
of common sense and daily observation. They know by ex- 
perience, which is the best teacher, that by thus shutting them- 
selves up, and observing a rigid performance of quarantine, they 
will escape unhurt ; and the result proves they are right : nor 
are the accidental cases that occur amongst them, even should 
some of them not be satisfactorily accounted for, sufficient to 
shake their confidence in these measures of preservation. They 
know that their exemption from plague depends on their strictly 
adhering to rule ; whilst neglect or inadvertence will as surely 
subject them to attacks of this disease. 

Why, I would ask, is this disease so destructive among the 
poor, and those who are crowded together, where necessarily a 
more promiscuous intercourse takes place, than amongst the 
rich, in houses less confined, and affording more roomy ac- 
commodation ? It is not alone owing to the simple fact that the 
houses are larger and better ventilated, but that there is less pro- 
miscuous intercourse amongst them, than amongst the poor in 
common life ; and because, when once the disease gets into 
these miserable, ill-ventilated hovels, the persons being all 



ITS SYMPTOMS AND PROGNOSIS. 



s? 



huddled together, lying perhaps two or three in a bed, the fomes 
ferments as it were, and acquires more activity. This we fre- 
quently see in the fevers of this country. And why do those 
persons employed immediately about the sick suffer in a much 
greater proportion than others ? — a circumstance that has been 
noticed in all plagues ; for it is a notorious fact that dreadful 
mortality takes place amongst those unfortunate people, as well 
as amongst those employed in burying the dead, and in the 
service of expurgation. And why, I would also ask, are some 
places and houses preserved in the very midst of the malady, 
by being carefully insulated, as was the case in the Foundling 
Hospital, in Moscow, which was literally situated in the very 
hot-bed of plague, as described by De Mertins in his account of 
that plague. It is very true that, from a violation of quarantine 
laws, the plague got admission into that building more than 
once ; but it is also true that by watching over everything with 
the most jealous anxiety, De Mertins was enabled to lay hold 
of the persons ill of the plague who were guilty of the breach of 
the quarantine rules established by him, before they commu- 
nicated with the other inmates of the hospital, and thus 
effectually prevented the mischief that would have followed, had 
they not been detected in time. 

There can be no doubt but the active exertions of Dr. 
De Mertins, and his well-regulated quarantine restraints, pre- 
served that hospital from the plague, or rather arrested it 
promptly when, by a violation of his regulations, it had been 
introduced ; and a strong proof is afforded of the benefit arising 
from the system he adopted, and of what may be achieved by 
an active individual. Yet it might have happened that all his 
exertions were rendered nugatory to a certain degree by the 
negligence or bad conduct of some of the confidential persons 
serving under him ; for if, as sometimes happens, men in a con- 
fidential situation become so abandoned and lost to all sense of 
honour, and are so wicked and regardless of the sad conse- 
quences as to trample on the sacred laws of health themselves, or 

H 2 



88 



ORIGIN AND HISTORY OF THE PLAGUE ; 



to wink at their infraction by others, no place can be safe, and 
no punishment can be adequate to the offence. It is truly me- 
lancholy to reflect, yet it is nevertheless true, that if by any 
means one individual had clandestinely escaped from the hos- 
pital, when by great exertion and purification it had been got 
under there, and had had communication with the impested 
persons or effects in the city, and returned again without being 
discovered before his having had communication with the in- 
mates of that hospital, he might have carried the disease again 
into the very heart of that establishment, after all that had been 
done, and in all probability it would have been as fatal as it 
was in the rest of the city. As it was, the soldiers and work- 
men employed about the hospital were guilty of repeated vio- 
lations of quarantine ; but the active exertions of Dr. De Mertins 
prevented, or rather checked, the mischief by causing the 
speedy arrest of the offenders, and those having intercourse 
with them. 

This shows the indispensable necessity of preventing by 
every possible means all intercourse between healthy and un- 
healthy places in time of plague ; and although a person to all 
appearance in perfect health should escape from a place where 
the plague is raging, yet it would be madness to receive such a 
person or to have intercourse with him until his health is proved 
to be perfect and free from plague, which can only be done by 
keeping him for a certain time in strict quarantine.* 

* Whilst on this subject, I may mention what occurred to mj^self and the 
gentlemen who were with me when I arrived at the lazaretto of Ancona, on 
my return home from the Ionian Islands. 

On mentioning my name to the superintendent of the lazaretto, he said he 
knew pie by report ; and asked whether I had not been in charge of the 
plague-district of Lefchimo, in Corfu ; which of course I immediately ac- 
knowledged, hoping, at the same time, that he would not prolong the quaran- 
tine on that account, as I had not had the plague whilst so employed, although 
my health had suffered from the great fatigue and anxiety. He told me he 
did not know that he could shorten the period of quarantine ; but that, as he 
saw we were all in apparent good health, he would write to the government at 
Koine to that effect. He desired us all to handle and open out every part of 



ITS SYMPTOMS AND PROGNOSIS. 



89 



CHAPTER IV. 

The plague not communicable, like epidemic diseases, through the medium 
of the atmosphere— The efficacy of well-regulated cordons, as a security 
against the malady, as seen in Lefchimo — The sense of danger a good pre- 
servative — The foolhardy and those who violated the laws of quarantine 
the sufferers — Persons impested sometimes unconscious of their being so. 

If the plague were communicable through the medium of the 
atmosphere, like epidemic diseases, no precautionary measures 
could be of any avail, and no plan with which we are acquainted 
could preserve us from this awful calamity, as the grand prin- 
ciples of separation, segregation, and absolute non-communica- 
tion would be useless and of no effect. Then, indeed, it might 
be said, that the whole code of quarantine laws are not only 
inefficient, but cruel in the extreme. The contrary, however, is 
the fact ; and there is nothing more clearly established among 
enlightened nations than the advantages of a well-regulated 
police, both as a prevention of the evil and a means of sup- 
pressing it. 

our baggage, even to the most minute article, as well as our bedding. This 
operation he superintended in person, standing to windward all the time. This 
he desired should be done twice a day for seven days when the weather 
was fine, which orders were implicitly complied with ; and at the end of thirty 
days, including the day of admission and discharge, being all in health, we 
were liberated. 

The object he had in view by insisting on our handling everything was, 
that if any fomes of plague existed in any part of our baggage, we ourselves 
should have been the very first to suffer ; and reluctance to comply with his 
orders would have strengthened this suspicion, and prolonged the period of 
quarantine. I may remark, however, that having touched and handled every 
article we possessed, I conceive that he might have liberated us with perfect 
safety at the end of fifteen days, as I do not know, and am not aware of, any 
well-authenticated case of plague occurring after fifteen days from the last 
contact ; indeed, after eight or ten days, I consider the person safe ; and the 
knowledge of this fact ought, consequently, to shorten the period of qua- 
rantine. 



90 ORIGIN AND HISTORY OF THE PLAGUE; 

In the plague of Lefchimo, we had ample opportunities of 
knowing that the air was not vitiated during the prevalence of 
the malady there ; and we had the best proofs of what may be 
effected by a well-directed police. In an extensive tract of 
country — viz., about forty miles in circumference, where there 
were fourteen villages impested — the plague was never allowed 
to pass the principal cordon. The greater part of the medical 
and military officers, with the troops employed on that occa- 
sion, were lodged in these impested villages. The guards were 
continually traversing them, and performing their duties in and 
around the camps where the plague was raging, as well as 
around the barrier of the pest-hospital itself ; and sometimes, 
so close were they to the patients, that had they been inclined, 
they might have touched them ; yet, in no instance was any 
person attacked from these causes ; and I am bound to attribute 
the health of both men and officers to strict attention to, and 
conformity with, the orders issued (the necessity of which was 
strongly impressed on their minds), to avoid all contact 
either with impested or suspected persons or things ; and this 
was so well understood latterly, that from a regard to their 
own safety, and a full belief that by adhering to these injunc 
tions they would escape the malady, it would have been diffi- 
cult to have persuaded some of them, even by any bribe, to 
deviate from their orders. As a proof of this, I may mention 
that one of the muleteers employed in carrying provisions from 
the commissariat depot, stationed at Egrippos, to the camp, by 
accident dropped his handkerchief close to one of the people 
who were waiting to receive their provisions. He was soon 
after told of it, but would not take it up again, for fear, as he 
said, that some one having the plague had touched it. 

Yet some accidents of plague occurred amongst the troops ; 
and a very melancholy one happened in the detachment of De 
Rolle's regiment, stationed in Clomo, as will be noticed hereafter. 
But these accidents were invariably traced to violations of qua- 
rantine by those who had basely left their posts in search of 



ITS SYMPTOMS AND PROGNOSIS. 



91 



wine and plunder in the impestecl houses, and who had joined 
their comrades without this circumstance being known. It is 
distressing to think that the innocent should thus suffer with 
the guilty ; but so it was in these instances, and so it must be 
in the plague. 

I am fully persuaded that a person may appear to be in per- 
fect health and yet have the plague in his constitution or in his 
clothes without its being known even to himself. We had a 
remarkable instance of this in the plague of Corfu. One of the 
Greek papas belonging to Anaplades, named Metaxa, soon 
after the breaking out of the malady in Marathea, went to that 
village to assist at a congregation of the clergy there for burying 
the dead, and offering prayers to Heaven on the melancholy 
occasion. After he had finished his sacred duties, he returned 
to his family in Anaplades, amounting at the time to eight 
souls, including himself. A few days after his return home, his 
family began to fall sick, and in a few days more, six out of the 
eight individuals were either dead or dying. His only surviving 
brother, who as yet remained in perfect health, seeing the 
dreadful state of the family, made his escape from the house, 
and lived in a state of concealment in a distant part of the 
country, subsisting on wild herbs, and whatever else he could 
find, for some time afterwards.* The papa himself, the author 
of all this mischief, — ignorantly so, I allow, — was among the 
last attacked, and was afterwards taken to the hospital, where he 
recovered ; and as far as I know, he was the only one of the 
family who survived. For a long time he persisted in saying 
that he was sure he had not brought the plague into the family, 
although he readily allowed that he had been at Marathea, to 
assist at the ceremonies there, and had had free intercourse 
with the sick ; and that, as far as he was capable of judging, 
he thought the disease there the same as that in his own family, 

* I was never able to ascertain whether this man had the plague or not ; 
nor, indeed, was I able to find him out, or get any account of him afterwards. 



92 



ORIGIN AND HISTORY OF THE PLAGUE; 



It was in this manner that the disorder was first introduced 
into Anaplades, and soon spread over that village ; for until 
his arrival from Marathea, there had been no sickness for some- 
time before, except a few cases of intermittent fever, to which 
the inhabitants are frequently subject. 

I myself was not in Corfu at the time this occurrence took 
place ; but the account which I have given was reported to me 
by several persons, and among the rest by Metaxa himself, who 
confirmed the account, so that I have no reason to doubt the 
truth of it ; and the impression on my mind is, that he got the 
plague at Marathea, and returned with it to his own house. 



CHAPTER V. 

Sad consequences of dilatory measures on the breaking out of plague — Neces- 
sity of choosing for the management of plague matters men of practical ex- 
perience and integrity — Necessity of liberally rewarding and placing above 
temptation persons in plague service— Danger of being thrown off our 
guard by the lulling or apparent cessation of the malady — Plague not so 
regular in its periodical visitations as has been supposed — Prevailing notion 
of the Franks on this subject — In plague countries the malady is not al- 
ways in the same state of activity at the same periods — Is not affected by 
extremes of heat and cold — These may, however, modify its type — Any 
supposed benefit arising from these extremes not to interfere with the plan 
of management for suppressing the calamity. 

The history of almost all plagues shows us how greatly it is to 
be deplored that much valuable time is lost in the beginning, 
before the prevailing disease is pronounced to be the plague ; 
and how unwilling people are to believe it to be so, even when 
decided symptoms manifest themselves, until they are perfectly 
overwhelmed by it, when it becomes impossible by any human 
means to put an immediate stop to it. This difficulty is always 
in proportion to the extent of a plague ; for when immediately 
pronounced to be such, and before it is allowed to extend itself by 
communication, it may be easily suppressed at its commencement, 



ITS SYMPTOMS AND PROGNOSIS. 93 

but becomes a most painful and laborious operation afterwards. 
It is owing to this unwillingness to allow that the plague exists, 
that well-arranged plans for its suppression have been frustrated, 
and that disgrace has sometimes been attached to these plans ; 
for it is not to be supposed that those who disbelieve its actual 
existence in a place will become easily reconciled with the 
orders issued unless they are compelled to do so ; and, indeed, 
in some cases it will be found that nothing less than strong 
measures will do. 

I remember, for instance, that in the plague of Lefchimo, one 
of the principal men in that place, the primate, or chief magis- 
trate of Milichia, named Canta, whose wife, a fine young 
woman, with her child, were attacked towards the decline of the 
malady by the disease, and died with the most unequivocal 
symptoms of plague, persisted to the last in maintaining that 
they had not the plague, but that the prevailing disease was a 
different one. This man complained most grievously of my 
supposed cruelty in sending his wife, then in a dying state, to 
the pest-hospital, although she had a large bubo in the axilla, 
a carbuncle in the ham, and petechia on her body. The poor 
woman died in a few hours after her admission, and shortly 
after her infant too, who was between two and three years old, 
covered with petechia. On the first appearance of the disease 
in this family, which consisted of four persons, the whole were 
immediately removed from their house. The two sick — viz., 
the mother and child, were sent at once to the hospital. The 
man himself and the maid- servant, who appeared to be in perfect 
health, were put into the class of strongly or highly suspected, and 
kept rigidly apart from all the others. They did not contract 
the disease, and were finally released and sent to their homes 
at the expiration of their quarantine, during which they were 
employed in purifying the effects they had brought along with 
them, so as to remove all suspicion from them. The maid had 
carried the child to the camp from Milichia, a distance of about 
five English miles ; and 1 learned that Canta himself had slept 



/ 



94 ORIGIN AND HISTORY OF THE PLAGUE; 

with his wife the night before. Yet they both escaped. As 
both the master and the maid-servant were in health at the 
time I ordered them into the camp, the primate was ex- 
tremely unwilling to be subjected to the necessary restraints ; but 
I was obliged to act towards him with firmness and decision. 

The death of this beautiful young woman, whose name was 
Regina, made a great sensation in the town and neighbourhood. 
She might well have been named the Queen of Lefchimo, for 
she was one of the handsomest women I ever saw. 

In conducting the matters of police in the time of plague, 
it is to be observed that the necessary arrangements, at least 
on an extensive scale, cannot be framed and earned into effect 
at once, except by those conversant with these various duties. 
It is practical experience alone, aided by a thorough knowledge 
of the subject, that can direct the necessary operations ; and 
most commonly many of the persons employed are to be taught 
the parts they have to perform, else, by ignorance or mis- 
management, they may be the means of extending the very 
disease they are called upon to suppress. 

In the selection, therefore, of persons to be employed in the 
higher and more confidential branches, it would be well to 
choose only those on whose integrity we can depend, and 
who possess strong minds ; such persons ought to be most 
liberally rewarded for their services, and placed above all 
temptations to swerve from their duty. 

It too frequently happens in the time of plague that the 
very persons employed in suppressing it, from an idea that all 
danger is over, (merely because the disease is lulled for a time, 
and which indeed is a remarkable trait in its character,) begin to 
relax in their duties. This is a serious evil, and cannot be too 
sedulously guarded against. The calm is most apt to deceive 
us at the beginning, when doubts are still entertained respecting 
its after nature, and the general shock and consternation caused 
by its existence being proclaimed have subsided. At this 
moment of hesitation and doubt, the report of the physicians 



ITS SYMPTOMS AND PROGNOSIS. 



95 



and surgeons is favourable, in as far as regards the general state 
of the public health ; so that, perhaps, it will be found that there 
are fewer sick than usual. This was the case in Moscow, 
Malta,* Corfu, and many other places ; and this fatal security, 
if not guarded against, will always be productive of the direst 
consequences afterwards ; for it is during this interlude, if effi- 
cient measures are not in force, that the malady is extending 
itself by propagation, and becomes so difficult afterwards to be 
remedied. 

It has been commonly alleged that in plague countries the 
disease is regular in its approaches and termination, as we see 
in autumnal fevers ; that it begins in September and ends in 
June. But I apprehend, if we narrowly inquire into the matter, 
that we shall find this not strictly to be the case, but that it 
often appears earlier, (and the earlier, the more destructive it is 
supposed to be that season,) and, in fact, does not terminate on 
St. John's day, as is commonly believed, but continues, or at 
least may continue, more or less all the year round in some 
place or another. I know that the Franks are strongly impressed 
with the belief that if they pass that day, all is well, and that 
they are then in the habit of congratulating each other on their 
escape for the season. But some of them have had occasion 
to regret their laying aside their preservative measures so soon, 
on their becoming afterwards impested from intercourse with 
the people. 

It is certain, I believe, that in plague countries the malady 
has raged violently in some places, when in others, at the same 
period, it has created no particular sensation, or perhaps did not 
even exist. Thus it has been very destructive in Constantinople 
at a time when it excited very little attention in Grand Cairo ; 
and the same may be said of other places. With regard to 
civilized Europe, I think it will be found, on examining the 

* Dr. Calvert, in his papers on the plague of Malta, says that the general 
report of the physicians continued favourable for a period of about ten weeks 
after the introduction of plague into that island. 



96 



ORIGIN AND HISTORY OF THE PLAGUE ; 



annals of plague, that it has been in a state of activity in one 
place or another all the year round. And I do not imagine 
that its activity or inactivity can at any time be fairly attributed 
to the season of the year, unconnected with other circumstances. 
Without meaning absolutely to deny that season abstractly has 
no influence on plague, I give it only as an opinion that this is 
at best but doubtful. 

I know it is very commonly believed that extremes of heat 
and cold have an effect in mitigating this disorder ; and some 
respectable writers are of this opinion.* It is perhaps true 
that the mortality has been diminished during excessive cold 
weather on some occasions ; but it is equally true that on other 
occasions the mortality was as great as at any other time. 
The same may be said with regard to heat. Dr. De Mertins, 
in his account of the plague of Moscow, seems to think that the 
pestilential virus was greatly weakened by the excessive cold 
of winter, when by Reaumur's thermometer it was shown to be 
from 16 to 22 degrees below the freezing point. Let it be 
recollected, however, that the disease first made its appearance 
there in the end of November, when the degree of cold is always 
excessive, and continued to be propagated during the cold 
weather. Nor did it appear at all to be influenced by the heat 
there, which is sometimes as great as 90 degrees of Fahrenheit's 
thermometer. 

Speaking of the effects of heat and cold in plague, Sir James 
McGregor, in his Medical Sketches, says, pp. 110-11, "In one 
circumstance, there is a very generally prevailing opinion in 
regard to the plague — viz., that extremes of heat and cold stop 
the progress of the contagion. If this be true in regard to 
heat, it did not appear to be so in the army in Egypt in regard 

* If ever the one or the other have been of service in plague, it must have 
been owing to a different cause from their immediate agency. It may have 
been from their preventing the propagation of the disease, when persons are 
not tempted to go so much abroad ; and thus far they might probably be of 
service. 



ITS SYMPTOMS AND PROGNOSIS. 



97 



to cold. The period at which the plague raged most was 
in the coldest months." 

Although I am fully persuaded that neither heat, nor cold, 
nor local situation will effectually either prevent the breaking- 
out of the disease, or hinder its spreading, when it has once 
begun its course, I am disposed to think that they may have 
some effect in modifying its type, and in varying some of the 
symptoms. Thus, it appears to me that the pneumonic affection 
which was so common among my patients in Egypt, might 
perhaps be attributed to the cold weather at the time. But 
this I consider rather accidental than necessary. And Sir James 
McGregor ascribes the intermittent and remittent type, in which 
the fever made its appearance when the Indian army was 
attacked by the plague at El Hamet, to the marshy situation 
of that encampment. He remarks, at pp. Ill, 112, that the 
cases sent from the Bengal Volunteer Battalion, and from the 
other corps, when the army was encamped near the marshy 
ground at El Hamet, were all of the intermittent or remittent type. 

Presuming, therefore, that a certain modification of symptoms 
may take place from extremes of heat and cold, local situation, 
and other circumstances, this will tend in some degree to re- 
concile the discordant or diversified accounts given by authors 
who have written on plague, which are sometimes so different, 
as would almost lead to an opinion that they were not treating 
of the same disease ; but this position being admitted, the mys- 
tery which hangs over these contradictory statements becomes 
quickly unveiled. 

I have no objection whatever to the opinion being entertained 
that both extremes of heat and cold mitigate the violence of 
this disease, provided it does not induce us to relax in our 
operations for suppressing it. But we must not be led away 
with that idea, and in trusting to it, remain in a state of inac- 
tivity. We must go on with our plan of management, without 
paying any attention to heat or cold ; and we shall ultimately 
succeed, if things arc properly conducted. 



98 ORIGIN AND HISTORY OF THE PLAGUE ; 

Entertaining the idea that the malady will be mitigated by 
these supposed causes, may be sometimes of service in removing 
the despondency which is apt to hang over the mind in the 
time of plague, and which, in spite of all our efforts to prevent 
it, will affect even the strongest mind at times ; and in so far as 
that belief tends to fortify it at a time when it is ready to sink 
under that accumulated horror and distress which cannot be 
known but by those who have been engaged in this duty, it is 
very proper, and even desirable, for the mind brooding over 
the misery and woe which everywhere surrounds us, is apt to 
become weak and melancholy, and requires every possible 
encouragement and support. 

It ought always to be kept in view that at whatever season of 
the year the disease happens to appear, whether in the spring 
or autumn, in the heat of summer or the cold of winter, we 
are not to trust to the chance of its not being very destructive, 
but we must adopt the proper measures with firmness and 
promptitude from the very conmencement, and continue them 
till the disease is finally suppressed, or we shall have cause to 
regret the relaxing them, and perhaps have the work to begin 
over again, when we least expect it. 



CHAPTER VI. 

Suddenness of the attack of plague exemplified. 

It has been said that at times the pestilential attack has been 
so sudden and violent, that persons have all at once dropped 
down dead on opening a trunk or even a letter where the con- 
tagion had been confined. I am inclined to doubt this, at least 
to this extent ;* but that its attack is sometimes very sudden, 

* On this point — viz., the time when plague symptoms begin to show them- 
selves after the first exposure, Dr. Russell remarks, in page 195, " In what time 
after its reception the pestilential virus begins to discover itself is a point of 



ITS SYMPTOMS AND PROGNOSIS. 



99 



is obvious from various circumstances that occurred during the 
plague in Lefchimo. 

Shortly after its breaking out in the village of Perivoli, some 
of the robes belonging to one of the clergymen, who had died 
of the prevailing disease, were carried to one of the churches as 
a place of security, (for at this period it was not generally believed 
that the malady was plague,) and were shut up there in the 
small room where they were usually kept. 

Soon after this, Lieut. Peretti of the Corsican Rangers, with a 
party of his regiment and some expurgators, were sent dowm 
thither, to purify the place, and enforce quarantine measures. 

About two months from the time the disease had appeared, 
when they were clearing away the things from the impested 
houses, and placing them in a depot for safety, until it should 
be finally determined by the government what was to be done 
with them, another papa, belonging to the village, mentioned 
to Mr. Peretti that there were some of the church-robes in the 
church, in which I believe Mr. Peretti was living at the time ; 
adding, that he wished to get possession of them, doubtless 
conceiving them not to be impested, and wishing to prevent 
their being sent to the depot with the other articles. Without 
knowing, or reflecting on the consequences of complying with 
this request, as doubts were entertained whether they really 
were impested or not, at the same time being importuned by 
the priest, who said he was quite sure they were not impested, 
(and we must at least give him full credit for his belief,) as a 

difficult discussion. The period, from unknown causes, varies in different sub- 
jects ; but its effects, in some instances, seem to be almost instantaneous ; or, 
at least, become perceptible in a few hours. I venture to assert this from the 
having known persons who had long been shut up taken ill almost immedi- 
ately, or in a day or two, after their coming out from confinement." 

" Mr. Bertrand places the extreme term at thirty-five days, beyond which 
no instance was observed at Marseilles." "In Aleppo," Doctor Russell remarks, 
" amongst those who were taken ill after their entrance into confinement, and 
supposed to have contracted the infection before their shutting up, I met with 
no instance of the disease discovering itself later than the ninth or tenth day." 



100 



ORIGIN AND HISTORY OF THE PLAGUE ; 



period of two months had elapsed since they ha4 been placed 
tlfere, and nearly forty days from the last case of plague in the 
village, Mr. Peretti gave him permission to have them examined 
to ascertain in what state they were ; for during these two 
months the room had been carefully shut up, and no person 
whatever permitted to enter it, at least during the time of that 
officer's stay there. As soon as the priest began to handle 
them, he was taken ill with staggering, stupor and other 
symptoms of plague. A few hours after, he was ordered to be 
carried to the pest hospital, distant about a mile, by the Con- 
dannati, and died before he reached it, no glandular affection 
or petechia being observed on his body. 

The above is the substance of Lieutenant Peretti's official 
report to General Phillips, who communicated it to me a few 
days before I went down to take the charge, and it was con- 
firmed to me from other sources as well as by the officer 
himself. 

When the disease had got into the village of Rummanades, 
as will be mentioned hereafter, some clothes in an impested 
house, belonging to the Capo d'Istria,* were put into a trunk, 
which for security was locked and nailed down, and left on the 
spot. When the house was ordered to be expurgated, this 
trunk happened to be still remaining there. Before the expur- 
gation of the house itself was considered finished, — for it could 
not be pronounced" to be perfectly so whilst anything remained 
in it, on which any degree of suspicion of plague rested, — one 
of the criminals was directed by Mr. Mazzenti, one of the di- 
rectors of the expurgation, to open the trunk and see what it 

* A family of this name, relations of the celebrated Count Capo d'Istria, the 
Russian minister, resided in Lefchimo. Being persons of consequence, they 
were indignant at being- subjected to quarantine restraint the same as the others, 
telling me they had no plague among them, and had not mixed with other 
families, (which I ascertained was not the fact,) and were extremely abusive, 
holding out threats if I did not liberate them. I merely replied that the laws 
of health made no distinction of persons, and were to be equally applied to the 
noble and the peasant, and that I could make none. 



ITS SYMPTOMS AND PROGNOSIS. 



101 



contained ; which with considerable exertions was effected. 
This man, named Constantino Castania, a stout fellow, about 
thirty-six years of age, when he began to handle the things in it 
was suddenly taken ill, and complained as if something had bit 
him about the neck. By and by, staggering, one of the most 
unequivocal symptoms of plague, came on; and in two days 
from the time he had opened the trunk he died in the pest hos- 
pital, having petechia and a large bubo in each axilla. During 
the delirium before his death he was constantly talking of the 
serpent, which he fancied to have bitten him in the neck. 
This coincides with the description of the plague given by Pro- 
copius, who says, " that the disease was announced by the 
visions of a distempered imagination ; and that the victim 
despaired as soon as he had heard the menaces, and felt the 
stroke of an invisible spectre." 

This man was a strong minded careless fellow, who hitherto 
had been quite regardless of handling the dead bodies or im- 
pested clothes ; and from this instance, as well as from the pre- 
ceding one, I am inclined to think that the pestilential matter 
acquires additional strength and activity by being confined. 

The clergyman in the case of the church at Perivoli appeared 
to be in perfect health at the time he received Mr. Peretti's per- 
mission to look at the things in the church : and the expurgator 
Castania was capable of making considerable exertion to open 
the trunk, but both, immediately .on handling the impested arti- 
ticles, were, as I said, taken seriously ill, and died very soon, 
without any doubts being entertained of the nature of the dis- 
ease, and, I apprehend, before any medicine could have had 
time to be of service to them. 

Another case occurred in some degree resembling the two I 
have just mentioned, and, I think, tending to confirm my opinion 
that plague contagion acquires intensity by confinement. 

One of the Condannati, named Spiro Bua, a stout man, aged 
thirty, had from the beginning of the plague been employed as 
a becca rnorte to bury the dead, and occasionally handled all 

i 



102 ORIGIN AND HISTORY OF THE PLAGUE ; 

sorts of impested things ; a daring, hardened, thoughtless fel- 
low, void of all fear and care, and who was often a volunteer on 
any dangerous and unpleasant duty. This fellow, like many 
of the others, was so totally devoid of fear from plague, that he 
could not be prevailed upon to wear the dresses and gloves that 
were ordered as a means of prevention. 

Being accustomed from the beginning to the horrid scenes in 
plague, and having hitherto escaped unhurt, he thought himself 
quite invulnerable. But on the 17th of May, nearly six months 
from the time he had been sent down to the plague district, he 
was employed under Mr. Mazzenti in expurgating the Casa 
Politi, which had been done but imperfectly before. It was 
very well known that a part of the infected cargo of goods to 
which the introduction of the malady was attributed, had been 
brought to this house, which belonged to a Greek merchant 
named Signor Politi, who had been long engaged in contra- 
band trade, about the very time that another part of the cargo 
had been landed at Marathea, in which village a great many 
persons had died of it. The deaths in the Casa Politi somehow 
or other were hushed up, as it was an insulated house, and was 
one of those which had been burned early in the business with 
the view of arresting the malady, and only imperfectly expur- 
gated afterwards ; for unburied bodies as well as quantities 
of impested things were lying about, in different parts of the 
house when I saw it. I therefore sent the whole corps of the 
expurgators under the two chiefs who were at that time em- 
ployed in the villages to finish this work as soon as possible. 

In performing that duty, which was exceedingly dangerous, 
Mr. Mazzenti, knowing how foolhardy the fellow was, desired 
him to take care of himself, and not to touch the impested things, 
or whatever dead bodies there might be, with his hands, but to 
use the hooks ; telling him at the same time, that although he 
had escaped hitherto, perhaps he might get the plague at last. 
He seemed, as usual, to disregard this advice ; and meeting, 
amongst other things, with the thigh and leg of a body in a very 



ITS SYMPTOMS AND PROGNOSIS. 



103 



putrid state, with part of the clothes adhering to it, he took it 
up in his arms, and carried it to be consumed. He was imme- 
diately seized with vomiting, and felt himself very unwell, 
which he himself imputed to something he had eaten, that had 
disagreed with his stomach, adding that he should soon get 
better. He, however, became gradually worse, with a consider- 
able degree of fever. By and by staggering, that well known 
symptom, came on, with a failure of voice, and very great pros- 
tration of strength. He complained of a burning heat all over 
him. He was sent, in fine, to the hospital, where he died the 
next day, covered with petechia, and with an immense bubo in 
the axilla, which he attempted to conceal.* 

In this case, also, which I conceive to have appeared in 
consequence of taking up the putrid limb, with the impested 
clothes adhering to it, where it had lain for about six months 
among the rubbish, after that house had been burned, the con- 
tagion in the clothes seemed to have gained strength. 



CHAPTER VII. 

Pestilential contagion usually very violent at the beginning : occasionally so 
during its course — March of the plague — Inquiry how it has been intro- 
duced : often by means of contraband goods, or mismanagement in health- 
offices— Great advantage of the early application of the proper remedies 
in suppressing it exemplified in Cephalonia — The general principles for its 
suppression always the same — Separation and segregation — Difficulties to 
be encountered in arranging the classifications. 

I think it will be found that the pestilential matter or con- 
tagion, (for here I consider the terms to be synonymous) is 
generally more violent at its first development, and proves 
fatal in one, two, or three days ; and often without glandular 
affection, or even the external appearances after death, which 

* I mention the general character of this man, because, if he had been weak 
and timid, this circumstance might perhaps have acted as a predisposing cause. 

I 2 



104 



ORIGIN AND HISTORY OF THE PLAGUE ; 



are supposed to characterize this disease : so that we are often 
in doubt, at least in the beginning, to what cause to attribute the 
sudden deaths, as buboes, which have been considered essen- 
tial to the character of the disease, are wanting. Petechia and 
vibices are oftener present than buboes in this stage of the dis- 
order ; but sometimes, as I have already said, all external 
aj:>pearances whatever are absent, 

I have noticed that the contagious matter is remarkably active 
and fatal at the commencement of the malady : yet, in parti- 
cular instances, it is extremely so during its course : it strikes 
unaccountably at once. They who have touched the sick, or 
impested things, fall suddenly ill, and sometimes die without 
any apparent cause, or without exhibiting any particular marks 
after death ;* and those having communication with them carry 
home the disease to their own families, and of them also some 
die quickly, without having external appearances, whilst the 
longest survivors may exhibit both buboes and petechia. 

On the first introduction of the plague into any place, the 
people die suddenly and unaccountably ; and the attendant 
medical practitioner, whom I suppose to have been called in, 
becomes exceedingly perplexed at what is passing in the 
family, and quite at a loss to explain the unusual violence of 
the complaints with which his patients have been attacked. He 
sees them very ill, and some of them dropping off suddenly, in 
an unaccountable manner, but at first has no suspicion that 
their case is plague, as the sickness is confined to a few fami- 
lies, perhaps only to one ; whilst the town and neighbourhood 
are in general healthy. Perhaps, too, he himself may be one 
of the very first victims — and, with his death, which however 
produces a certain sensation, any further inquiry at the moment 
stops. If there are any more medical practitioners in the place, 

* Dr. Hodges, in his account of the plague of London in 1666, says, 
" The pestilence is more active than lightning; and the persons seized with 
it seem to he fallen into an ambuscade, of which they were by no means sus- 
picious ; and, therefore, they are by no means to be credited or regarded who 
affirm the progress of pestilence to be sensible even to the smell and sight." 



ITS SYMPTOMS AND PROGNOSIS. 



105 



they find shortly that some of their patients fall sick and die ; 
that the usual medical treatment does not answer ; that they 
lose more patients in a short time, or in particular families, than 
they ever did before ; and they naturally become anxious and 
disconcerted at such alarming and dismal occurrences. Some 
too, perhaps, in their own families fall sick, though they them- 
selves may continue in health. This necessarily excites the 
practitioner's attention to the more immediate and increasing 
evil ; and on weighing everything in his own mind, he begins at 
last to think that the disease is plague, in which opinion he soon 
becomes confirmed by the occurrence of the same kind of disease 
in other places in the neighbourhood ; and he learns that several 
persons among the families that were first taken ill have died 
in like manner suddenly, while others of them are unwell. 
Yet even in this stage of the progress of the malady, some 
feasible reason is given by way of otherwise accounting for it, 
and people are still unwilling to believe that the disease is really 
plague. 

The complaint still continuing among the families first taken 
ill, and the persons composing them dying off unexpectedly, 
while sickness in particular families that had hitherto been 
healthy starts up and increases, with purple or dark coloured 
spots occasionally appearing on the bodies of the sick, after 
which symptoms almost certain death ensues — all this produces 
considerable alarm amongst the sick families themselves, and 
in all their immediate vicinity. 

Whilst these things are going on, it is reported that some of 
the patients have buboes in their groins, or arm-pits, or about 
the neck ; perhaps carbuncles (commonly called boils) on some 
part of the body, and the medical practitioner on examining 
particularly his patients, finds that some of them have glandular 
swellings, which before had escaped his notice. Some of them 
are hard and indolent, and attended with very little pain, and 
no discoloration ; whilst others arc of a deep fiery red and 
extremely painful to the touch. The febrile symptoms are in 
some cases very moderate ; in others, uncommonly violenl 



] 06 ORIGIN AND HISTORY OF THE PLAGUE ; 

Consultations take place among the physicians, and the civil 
magistrates think it their duty to make inquiry into what is 
going on ; and although the public opinion is divided respecting 
the prevailing disease, yet they think it proper to recommend 
the adoption of some plan for the general safety. On a reference 
to the sentiments of the physicians, they find such discrepancy 
of opinion among them, as exceedingly embarrasses and per- 
plexes them. Some cling to the belief that there is no plague 
in the case ; whilst others persist in maintaining that the disease 
is nothing but the true plague, which calls for the most decided 
measures for self-preservation. 

It frequently happens, that after the first shock has been given 
to the public mind, the disease is lulled, and there is little or 
nothing heard of it for a time. This lull may probably happen 
from less intercourse with the sick families in the way of visiting ; 
for sudden deaths, from whatever cause they may arise, produce 
a certain degree of alarm, especially among timid persons, and 
although they perhaps visit relations, or any intimate acquain- 
tance, yet they are not likely to be so free in their visits as 
formerly. 

This calm, which succeeds to the general alarm, and some- 
times continues for many days, without being interrupted by 
anything extraordinary, leads to the belief that the suspicion 
of plague was ill-founded, and perhaps very unpleasant reflec- 
tions are cast on those who first proclaimed the disease to be 
plague, whilst the public in general congratulate themselves 
that there is no good foundation for a rumour of the kind, that 
no such calamity exists among them, and that there never was 
sufficient reason for spreading such a report and creating such 
alarm ; the more so, as even at this time, by an inquiry into 
the general state of the public health, it is found that there is no 
unusual number of sick ; nay, perhaps they are less numerous 
than they had been for some time before. 

But we ought to know thai it is just the very character of 
this treacherous enemy to appear inactive for a time, ( which 



ITS SYMPTOMS AND PROGNOSIS. 



107 



circumstance, if we are not aware of it, may tend to throw us 
off our guard,) and to start again with redoubled activity. It 
seems, at times, in a certain degree to exhaust itself by being 
diffused, and then to break out again with increased force — to 
have its violence so blunted as to be less deleterious at times 
than at others ; and this is always to be particularly kept in 
mind, or the most distressing consequences will follow. We 
must therefore watch its motions with the most jealous care 
from first to last, and not be misled by these apparent interludes 
of inactivity. 

I have given it as my belief that the noxious matter of plague 
becomes more active by confinement ; and it is an established 
fact, that by being freely diluted with atmospheric air, it 
becomes entirely dissipated, so as to be no longer hurtful. To 
illustrate this, let us suppose that some impested things are 
laid by for a time in a trunk or drawers, whilst other things, 
also containing the fomes of plague, are exposed to free venti- 
lation ; the things thus laid by, never having been expurgated, 
will assuredly reproduce the disease on being handled ; whilst 
those that have been exposed to the air, and from which the 
contagious matter has been thus expelled, are safe. Hence the 
absolute necessity in the time of plague of purifying everything 
suspected with the most scrupulous care ; and hence the great 
danger of hoarding up impested things during the awful period. 
I mention that the atmospheric influence will destroy the con- 
tagion of plague without supposing that this mode of expurga- 
tion is to be exclusively resorted to ; for as there is the greatest 
danger to those who handle the impested effects, or expose 
them to the air, no one valuing his life ought on any account 
to interfere with them. This operation is only to be executed 
according to rule by persons conversant in this branch of 
plague-service, who ought not only to be kept in strict quaran- 
tine during the time the process is going on, but they should 
also be strictly attended to for at least twenty days after the 
work is finished and they have undergone the complete spoglio. 



108 ORIGIN AND HISTORY OF THE PLAGUE; 

At the expiration of that term, if they are found on examination 
to be in good health, they may be released from all restraint. 

The concealing and hoarding up of impested goods, under 
the impression that they are perfectly free from the matter of 
plague, or that, if they were really contaminated, they would 
soon lose their noxious quality by keeping, was one of the most 
vexatious circumstances we had to contend with during the late 
plague in Corfu, and which was resorted to in the general con- 
sternation at the beginning before it could well be prevented. 

It is thus that the pestilential matter goes on increasing its 
volume by being propagated from an impested person to another 
who is in health, or by means of clothes and other things which 
contain the contagion, till it becomes at last so widely extended, 
that the management of it is found a truly Herculean labour ; 
for as a neglected spark may cause the most dreadful confla- 
gration, so may the smallest impested article be productive of 
the most calamitous consequences ; and if not arrested at the 
beginning, may compromise the health of whole nations, should 
nothing be done to counteract it. 

Whilst the public mind is in this unsettled state — for one 
now hears of frequent and sudden deaths in the surrounding 
families ; and every such report, from whatever cause it happens, 
creates extreme uneasiness and anxiety — it is found, notwith- 
standing all that has been said to the contrary, that there is a 
great increase of sickness and a much greater mortality than 
usual. Frequent consultations take place among the physicians 
and surgeons on the prevailing disease ; and some, who at the 
beginning resolutely denied the existence of plague, become 
staggered in their opinions, or allow the disease to be the 
plague, while certain individuals still obstinately maintain that 
it is no such thing. 

The alarm and consternation by this time have become 
general, and the true nature of the calamity can be no longer 
mistaken ; nor has the pertinacious obstinacy of the few who still 
hold to their first opinion any weight with the community at large. 



ITS SYMPTOMS AND PROGNOSIS. 



109 



The magistracy now begin to act in concert. Different plans 
and arrangements are proposed, but none of them are acted 
upon with promptitude and vigour. Indecision marks their 
resolves, and they hardly know what to do for the best ; yet all 
agree that something must be immediately set about. 

By this time the malady has become so deeply rooted in 
some parts, and so widely extended by propagation, that whilst 
they are deliberating on what is proper to be done on this 
emergency, reports of various deaths among their friends and 
acquaintance still add to their perplexity and uncertainty. 

Although at the beginning the symptoms of plague were 
doubtful, and external appearances, at least, in many cases, 
were wanting, yet now, at last, it is found that the various 
eruptions, the strongest characteristics of the disease, are very 
frequent, and that buboes, carbuncles, petechia, and vibices, ac- 
company the general train of the other symptoms, which, per- 
haps, had been studiously concealed before. The deaths become 
still more frequent, and usually happen before the fifth day from 
the period of the attack. Some linger beyond that day ; but 
it is found that the greater number die on or about the third. 

In this dire dilemma, and whilst, perhaps, indecision prevails 
in the magisterial councils, not proceeding from any apathy or 
indifference, (for by this time I can hardly imagine that any 
one could be indifferent to what is passing around,) but from 
really not knowing how to act in so critical an emergency, the 
calamity, by unrestrained intercourse, still continues to disse- 
minate itself more widely, and the people rapidly fall sick one 
after another. 

A council, or board of health, composed of respectable indi- 
viduals, with whom some of the medical practitioners are asso- 
ciated, is, perhaps, by this time appointed, and certain arrange- 
ments are recommended and adopted. But unless there are 
some among those mentioned who understand the march and 
police treatment of the plague, all becomes a scene of confu- 
sion, and in their zeal to do what is right, they will be apt io 



110 ORIGIN AND HISTORY OF THE PLAGUE; 

act contrary to one another, and thus increase the evil which 
they are so anxious to put a stop to ; whilst the severity of the 
regulations, if they are well arranged, gives serious offence to 
many, who consider them to be extremely cruel. And although 
all are ready to admit that some judicious plan should be 
adopted, they will be apt to disagree as to the precise mode of 
carrying it into effect, and even to act contrary to some of the in- 
structions of the board of health, however well framed they may be. 

It now, perhaps, becomes a matter of inquiry, how the plague 
had got among them ; for it can be no longer doubted that the 
disease (as energetically described by Sir Thomas Maitland in 
the plague of Corfu, on his arrival there) * is the plague, the 
whole plague, and nothing but the plague" and all that the most 
sceptical persons can urge is insufficient to shake that opinion. 

On inquiring into the manner by which it has been intro- 
duced, we find that many surmises are made, and suspicions 
fall on several as being concerned in it. Some of these sus- 
picions may, perhaps, be well founded ; but even if they are 
so, it is not likely that we shall get at the truth ; for no promise 
of reward or dread of punishment will induce those conscious 
to declare the fact, either of its introduction or subsequent 
propagation during its first development ; and to obtain this 
information, we must entirely depend on our own inquiries and 
conclusions, tracing it from the first sudden death or deaths of 
persons which were not satisfactorily accounted for (as belonging 
to ordinary complaints) to others who were attacked in a like 
manner, and from whom we shall learn, on stricter investiga- 
tion, that they had had direct intercourse with the first. On 
making this inquiry, we shall find, that although some of the 
persons subsequently attacked have had direct communication 
with the first sick family or families, yet others, who have also 
had intercourse with them, continue in perfect health. But this 
must not deceive us, as we know that this capricious disease will 
sometimes attack one individual in the most violent manner, 
and leave others of the same family untouched : whilst, on the 



ITS SYMPTOMS AND PROGNOSIS. 



Ill 



other hand, it will often attack a family, and never leave it but 
with the destruction of the whole. 

As it frequently happens that it is introduced by contraband 
goods, or from deceiving the officers of health, or perhaps in 
consequence of these last conniving at the contraband traffic, 
it is almost impossible to come at the truth, from the dread of 
the punishment these persons know they deserve, which they 
are aware hangs over their heads, and which, by keeping the 
matter a profound secret, they may escape. They are so fully 
aware of the heinous nature of the offence they have committed, 
that neither the promise of pardon nor any reward will induce 
them to make the discovery demanded. And, indeed, if they 
are possessed of any feeling, and reflect on the general misery 
they have caused, I do not wonder that they should attempt to 
conceal the part they have acted in so unhappy an affair. 

Moreover, it may happen that the persons who had brought 
in the disease may one and all have become its victims, so that 
we have no means of getting any previous, nor, indeed, any 
subsequent account of the transaction, unless what may arise 
from the propagation of the disease among those who had in- 
tercourse with them. And as, perhaps, the malady of which 
they fell sick or died is never dreamt to have been plague at 
the time, no measures of precaution were adopted, nor, indeed, 
was any alarm excited on the occasion. 

I shall speak in another place of the manner in which the 
malady was introduced into Lefchimo ; but I may here mention 
that I understood, from undoubted authority, that the wife of the 
captain of a smuggling vessel, which all accounts agree had 
brought the disease to the island, died at Perivoli, where she 
went to visit her relations, a village situated about a mile from 
the place where the vessel landed part of her cargo, and before 
the disease broke out either in the Casa Politi, the place at which 
the goods were landed, or at Marathea, where it first excited 
alarm. It is true that at that time it was not known of what 
disease she died, Hut the accounts 1 received stated that she 



112 ORIGIN AND HISTORY OF THE PLAGUE; 

had died suddenly, and that immediately afterwards the captain, 
her husband, set off with his vessel. I do not mean positively to 
say that she died of plague, nor was it ascertained what she 
died of, but her sudden death about that time rendered it 
highly suspicious. Yet it is proper I should state that if the 
disease was plague, it did not spread in that village till some 
time afterwards, (the precise time after her death I never could 
learn,) when its introduction thither was satisfactorily traced to 
another source, as will be shown hereafter. 

I am not fully informed of the manner in which the malady 
was introduced into the island of Cephalonia; but according to 
the accounts I had, and partly from a letter which I got from 
Mr. Tully, who had been ordered from the service of Lefchimo 
on that duty, it appears to have originated in some neglect or 
inattention of the officers of health, who, while the plague was 
raging on the opposite coast of Albania, were not sufficiently 
careful in examining into the state of the health of the persons 
arming thence ; nor of causing the effects they had brought 
with them to be properly purified before they were admitted to 
free pratique. I understood also that the quarantine betwixt 
Cephalonia and the Continent was ill regulated, and that its 
duration did not exceed seven or eight days at the time the 
plague broke out. 

The actual existence of the plague in Cephalonia being im- 
mediately ascertained, no time was lost in applying the proper 
remedies for suppressing it, before it had time to extend itself ; 
and in this instance they were eminently successful.* The mon- 
ster was crushed and finally extinguished, almost as soon as he 
had begun to rear his head. Thus, one of the strongest proofs 
recorded in plague annals is given of what may be achieved by 
prompt measures in the beginning, when, comparatively speaking, 

* This was done the more promptly, as our operations in Lefchimo were 
drawing to a close, and everything going on favourably, which enabled me to 
spare a party of the expurgators, with one of the chiefs, some of the troops 
and guardians who were conversant with this service, for that duty. 



ITS SYMPTOMS AND PROGNOSIS. 



113 



it is an easy matter. The almost immediate discovery that the 
disease was plague and only plague was the great difference be- 
tween the plague of Cephalonia and that of Corfu, where, from 
various causes, it was permitted to extend itself and linger for a 
considerable length of time, whereby the carrying into full effect 
of the necessary measures with promptitude and decision was 
prevented, and which ultimately led to very calamitous con- 
sequences. 

But although it is always very desirable, for many reasons, 
to ascertain the manner in which plague comes to be introduced 
into a place, yet in as far as regards the means to be adopted 
for its suppression and final eradication, it is really of little 
consequence ; for by whatever means it has been brought, (and 
I consider it decidedly as an imported disease, as well by land 
as by sea,) the general plan of management is the same in all 
cases — viz., shutting up the people in their houses ; the prin- 
ciples of separation and segregation fully acted upon ; the en- 
forcement of rigorous quarantine ; the establishment of cordons, 
and the purification or expurgation of everything in which the 
contagious matter may be supposed to exist. The great point 
is to ascertain that the disease is plague ; and that once done, 
not a single moment is to be lost. The road is then straight- 
forward, from which we are not to deviate either to the right or 
the left. 

However painful it may be to those employed on this duty, 
and however those suffering from the ravages of the disorder 
may designate the proper remedies as cruel, harsh, and unneces- 
sary, as they no doubt will be considered by those ignorant of 
the matter, and by the unfortunate persons who are the sufferers, 
yet all this is no reason for relaxing in their application ; and 
it will be found the best policy to act with impartiality and de- 
cision in an affair of such vital import; for we ought never to 
forget the maxim, that what may be considered cruelty to indi- 
viduals, is charity and mercy to the community at large. 

But whilst the laws of health and regard to the general safety 



114 ORIGIN AND HISTORY OF THE PLAGUE; 

compel us to separate those actually impested, as well as those 
only suspected, from the general mass of the population, still 
this important, though peculiarly unpleasant duty, is not to be 
done in a capricious and unfeeling manner. We must never be 
actuated by ill-will on the sad occasion, but, on the contrary, 
use all the mildness and conciliating discretion in our power ; 
for it would be monstrous to add wantonly to the public misery by 
unnecessary harshness and severity. I am sorry, however, to say 
that it will be difficult sometimes to avoid having recourse to 
measures of severity ; for obstacles will be thrown in the way of 
this most necessary and important duty, and deceptions will be 
practised which may lead to much embarrassment and unneces- 
sary rigour, of which those only can have an idea who have 
been employed on such a service. In the plague of Lefchimo, 
whenever the disease started in a place, it became the duty of 
every one to ascertain to what cause it was owing, and who the 
persons were concerned in it; for we never for a moment 
imagined that it sprung up from the earth, or that it was in the 
air, or was caused by the climate, or, in short, that it depended 
on any cause separate from the principle of contagion ; and 
acting on that principle, we were always able to explain its ap- 
pearance in a place. We not only ascertained that it was 
owing to some violation of the laws of quarantine, but we pur- 
sued it closely through those who had had communication with 
the aggressors, and immediately separated all of them from the 
community. 

In the investigation of this subject, which was renewed as 
often as the plague made its appearance anywhere, we were at 
times not a little perplexed by contradictory information ; the 
guilty resolutely denying all knowledge of the fact, and per- 
sisting in asserting their innocence ; whilst those whom we had 
the greatest reason to suspect of having had intercourse with 
the sick, or were any way concerned in the matter, as firmly 
maintained their scrupulous adherence to the orders issued for 



ITS SYMPTOMS AND PROGNOSIS. 



115 



preventing all intercourse, except under the directions pointed 
out to them. We found also, on more occasions than one, that 
certain persons, bearing ill-will towards their neighbours, ac- 
cused them, though innocent, whilst they tried to screen their 
friends, though guilty. The inquiry, therefore, became at times 
very painful. Yet, even at this distant period, I am satisfied, 
with regard to Lefchimo, that no unnecessary harshness was ever 
had recourse to, but that, on the contrary, every proper dis- 
cretion was used. 



CHAPTER VIII. 

The necessity of shutting up on plague being proclaimed — Of avoiding all in- 
tercourse, and of impressing this on the public mind — Several of the people 
of Lefchimo guilty of violating the laws — Indisposition during the period 
of quarantine. 

Immediately on plague being proclaimed in any place, one of 
the first steps to be taken is to direct the people to shut them- 
selves up in their houses, and to avoid all intercourse, either 
direct or indirect, with their neighbours. All congregations or 
meetings of the people are to be most strictly prohibited, as well 
those for amusement as for the public performance of religious 
duties. These measures may appear to some to be harsh and even 
impious, but they are nevertheless absolutely necessary; and 
unless this is done, and scrupulously attended to, all our efforts 
to suppress the calamity will be unavailing. It is not to be ex- 
pected that at first the people will tamely or quietly submit to 
such rigorous measures, but they will naturally try to cir- 
cumvent them. These measures, however, must be enforced, 
and, assuredly, the more strictly they are adhered to, the 
sooner will the plague be arrested, and the shorter will the time 
be during which these measures are required.* 

* The supply of all their necessary wants while thus shut up becomes, as I 
have already noticed, the duty of the civil magistrates. 



116 



ORIGIN AND HISTORY OF THE PLAGUE ; 



It is of the highest importance to impress on the public mind 
generally, as well as individually, the great danger of haying 
communication with one another ; that it is a disease only com- 
municable by contact, and that, by avoiding all contact with 
impested persons or things, they will certainly escape ; whilst, 
on the other hand, by coming into immediate contact even with 
a person who to all appearance is in perfect health, they may 
contract the disease. They ought to be taught to dread 
touching any person or thing that they do not know to be 
positively free from plague, which is indeed a paramount inter- 
diction of everything or person beyond their own immediate 
houses or families. They ought not even to receive a letter 
from their friends until it is first purified. If these measures of 
insulation are frilly attended to, they who observe them will ex- 
perience the benefit accruing from them, whilst their less care- 
ful neighbours will be seen dying around them from the neglect 
of these salutary precautions. 

This dread of plague from touching objects not known was 
strongly impressed upon the minds of the inhabitants of 
Lefchimo, and proved one of the most powerful means of pre- 
venting intercourse between them, although, indeed, some con- 
tinued sceptical on that point. 

As an instance of this dread of contact, I may mention that 
during the early part of the plague in Lefchimo, the season 
being uncommonly cold and rainy, and the soldiers, particularly 
in the camps, having often to sleep in their wet clothes, it was 
suggested by some one, that it would be proper to have an 
orderly great coat left at the places where the permanent sen- 
tinels were stationed, in order that, whenever the sentry should 
come to be relieved, he should hand it over to the one suc- 
ceeding him, and then unroll and put on Iris own dry one. This 
at first seemed an excellent expedient, but the men themselves 
refused to take advantage of it, fearing lest, if by chance any 
one of them should become impested, the whole of them might 



ITS SYMPTOMS AND PROGNOSIS. 



117 



thus catch the disease, and they preferred remaining in their 
own wet clothes to running such a risk. 

But whilst T mention this trifling circumstance, by way of 
showing the effect of thus impressing the minds of the people 
with a sense of the clanger of touching or handling things 
which, for all they know, may be impested, I must add with re- 
gret that not a few of the Lefchimites acted contrary to the 
orders and instructions issued; and there were not wanting 
persons who had so little regard to their own and the public 
safety, as to rob the impested houses, and thus, in despite of 
the salutary regulations issued, to disseminate an evil which it 
was so very desirable to put a stop to ; and these breaches of 
the law were invariably followed by fresh mischief, not only to 
the parties themselves, but unhappily also to those who were 
innocent of the unpardonable transaction. 

If there is any truth in the doctrine of contagion in the 
plague, and if there is any necessity for adopting quarantine re- 
gulations, — which I suppose few will deny, — it follows that indis- 
position during the performance of quarantine, from whatever 
cause it may proceed, cannot be viewed without more or less 
suspicion. The plague we know to be a most treacherous 
disease, and to assume a variety of shapes, particularly at the 
beginning, and it is on account of the uncertainty as to how such 
indisposition may terminate, that the public health demands not 
only that the sick person himself, but every one who has come in 
contact with him, should be forbidden all free intercourse with the 
community at large, until the complaint under which he labours 
is fairly ascertained not to be plague. Then, and then only, 
ought such persons to be permitted to have free intercourse with 
the community by the taking off of the quarantine restraint. The 
object of all quarantine laws being to prevent plague from 
spreading by contact with the impested, if the disease under 
which any one labours whilst performing quarantine (for ex- 
ample, in a lazaretto, after coming from a plague country,) is not 

K 



118 



ORIGIN AND HISTORY OF THE PLAGUE; 



plague, which, however, must be clearly ascertained before he is 
liberated, he can suffer no harm beyond his temporary confine- 
ment. But if the disease is really plague, he is then in his proper 
place, and must be kept there till the disease is extinguished. 

It is on this account that the attendance on a quarantine 
establishment becomes at times a very disagreeable office to the 
medical practitioner ; and should he happen to come in contact 
with his patient in the lazaretto, he, too, must be subjected to 
the necessary restraint ; for, whilst any doubt on the nature 
of the indisposition exists, no one, as I have said, who has had 
communication with the indisposed person, ought to be allowed 
free intercourse with the community, until it be ascertained 
that the case is not plague. Medical men may think this hard ; 
and it must be allowed that it may be extremely inconvenient 
for them on many accounts. But the barrier of health cannot 
be broken down with impunity in favour of any one. It admits 
of no preferential regard or affection. If the practitioner, how- 
ever, has not touched his patient, nor anything belonging to 
him, the case is different, and there is no necessity for his 
being placed in quarantine. 

But although in time of plague the laws of health ought not 
to be influenced by either favour or affection, or even by honour, 
in the common acceptation of the term, I think that circumstances 
may occur in which individual modification may be practised 
with safety. Thus, persons coining from a place where the 
plague is known to exist, if such had shut themselves up, and 
had carefully avoided all intercourse by which they could con- 
tract it, it is obvious that those persons ought not to be sub- 
jected to the usual protracted period of quarantine, and a few 
days of observation are quite sufficient ; but, on the other hand, 
when these precautionary measures have not been properly 
attended to, a longer period of observation becomes necessary — 
say, twelve or fifteen days, during which time they must purify 
themselves, and handle all their susceptible effects ; if at the end 



ITS SYMPTOMS AND PROGNOSIS. 



119 



of that time no plague symptoms make their appearance, (and 
which is barely possible,) they may be released. 

A distinction ought also to be made betwixt men-of-war and 
merchant ships ; as in the former it is not to be expected that 
concealment will take place, whilst with regard to the latter, it 
not unfrequently occurs that cases of positive plague have been 
resolutely denied, and carefully concealed from the inspectors of 
health. 

We know that persons in quarantine are not exempt from 
ordinary indisposition ; and it will be alleged to be the height of 
cruelty to subject those labouring, perhaps, under a common 
malady to what may be considered such harsh treatment. To 
those who argue thus, I have only to say that plague is of such 
a Protean nature, that it often assumes at its commencement 
the appearance of a common cold, or intermittent fever, and of 
various other diseases, from which it is impossible for a time to 
distinguish it ; but, as I have already noticed, until with time 
the disease, whatever it may appear to be, is ascertained not to 
be plague, the sick person or persons ought not to be liberated. 
When once that is perfectly known, there can be no reasonable 
objection to remove all restraint. 

It is extremely to be regretted that there are not positive or 
specific symptoms always present, which point out to us at once 
this formidable disease, whereby we could immediately pro- 
nounce such a distemper to be, and such another not to be, 
plague, with the same degree of certainty as we speak of the 
measles or small-pox. But the plague often affords no such 
decided symptoms If such always were present, it would save 
much distressing anxiety as well to the physician as to the 
patient, and all parties concerned. It would prevent the sick 
from experiencing, whilst performing quarantine, what they 
may naturally enough think severe and cruel treatment. 



120 



ORIGIN AND HISTORY OF THE PLAGUE ; 



CHAPTER IX. 



Plague-contagion considered as capable of being transported from place to 
place — Has been imported into England — May be so again — Merchants 
anxious to have quarantine restraints removed. 

It is a prevailing opinion among merchants concerned in the 
trade of the Levant, as well as of some medical men, that the 
plague cannot be brought to this country in goods. To such I 
would reply — Is there any truth in the impregnation of certain 
substances with contagious or infectious matter, and in the 
opinion that the articles thus impregnated can be transported to 
a distant place without their losing the contagious or infectious 
quality so acquired ? If I am answered in the affirmative, 
then why deny that the fames of plague may be among the 
number ? If in the negative, then there is an end at once to the 
doctrine of contagion and infection, and all that we have ever 
heard or read upon the subject falls to the ground. I would 
ask still another question — Is there any inherent principle in 
the matter of plague which prevents it from being transported 
from place to place, as some other diseases are allowed to be ? 
And why might not a bale of cotton, or articles of that descrip- 
tion, be impregnated with the forties of plague, and be carried 
to a distant part, even from Aleppo, Smyrna, or any other plague 
town or country, to England ? 

It is affirmed by some, that the plague was never brought to 
England in merchandize, and that the dreadful disorder that 
prevailed in London in 1666 was not plague. It is asserted also, 
that if even we were to embark a bale of cotton impregnated 
with the contagion of plague from any of those distant countries, 
it would, by the length of the sea voyage, be rendered totally 
inert by the time it reached this country.* 

* The case of the clergyman of Perivoli, mentioned in another place — that 
of the expurgator Constantino Castauca, and of another expurgator, Spivo 



ITS SYMPTOMS AND PROGNOSIS. 



121 



They must indeed be sceptical who attempt to deny that 
the calamity which overwhelmed London in 1666 was not 
plague. If it was not, then there is no such disease as plague. 
I have seen the plague in Egypt, I have also seen it in Corfu. 
I have read with attention accounts of that of the period I men- 
tion, as well as those of various years preceding, and I have not 
the smallest hesitation in saying that it was the plague, and no 
other disease. Nor can it be considered as any proof of a 
contrary opinion that they did not all exhibit the same train of 
symptoms ; for we know perfectly well that no two plagues were 
ever precisely alike, and that the disease is modified at times 
by circumstances which we cannot well understand, but which 
are generally attributed to climate, season of the year, mode of 
living, local situation, &c. For my own part, I cannot doubt 
that the Levant plague has appeared in England more than 
once ; and if that is admitted, — which I believe there are not 
many who will be found to deny, — and that in its progress here 
it showed as malignant a type as it usually does in the places from 
which it is imported, the possibility of its visiting this country 
again is no longer problematical ; and that if once it does so, it 
will be as fatal in its consequences as it has been, should effi- 
cient means not be adopted to put a stop to it. 

With regard to the assertion (for it is merely an opinion 
destitute of any proof) that this malady cannot be imported 
into England, judging from what we know of the adhesive nature 
of plague contagion, we ought not to theorize at all on this 
subject, or give credit to such assertions ; for if there is any 
necessity to attempt to destroy contagion or infection generally 
where it is supposed to exist, or to endeavour to prevent its 
spreading, it is doubly necessary to take every human precau- 
tion against the introduction of plague. Besides, we have under 

Bua, show the contrary, as far as they go; at least they prove that the 
power of plague may remain a considerable time in things without losing 
any of its virulent and destructive character. I am not aware that it is rendered 
inert by the lapse of any length of time. 



122 ORIGIN AND HISTORY OF THE PLAGUE; 

our very eyes the strongest proofs that plague is an imported 
disease ; and so many well authenticated instances of this 
appear in the records of the malady in question, both in our 
own country and abroad, that it is impossible to doubt the fact. 
Indeed, it is on the full admission of this that the laws of qua- 
rantine among civilized nations have been established, as the only 
possible means of securing them from this most awful scourge ; 
for if it is not in its nature contagious, then these laws are not 
only unnecessary and cruel, but highly inimical to our com- 
mercial interests. 

But before we can receive any speculative opinions on this 
subject, or permit them to be acted upon, it behoves us to look 
well to the matter, and not to be led away by any conjectural 
suppositions, or attempt to overturn a system handed down 
to us from such respectable authority ; which also seems to have 
been adopted, after the most mature deliberation, by those who 
suffered, most from the effects of free intercourse with countries 
where the plague existed. Indeed, I cannot conceive any other 
good reason but a regard to their personal safety that would have 
ever induced people to impose upon themselves such severe 
restrictions as the quarantine laws unquestionably are in the 
abstract, and which among civilized nations seem to have been 
carried into effect almost by universal consent. And that they 
have been successful, at least to a certain extent, and would have 
been completely so but for their occasional violation, any unpre- 
judiced person may see by the immunity from plague which the 
nations of Europe have experienced since the adoption of these 
laws as compared with what they formerly suffered. It is to the 
active operation of the laws of quarantine that I am disposed to 
attribute not only our own exemption, but also that of the rest 
of Europe : nor can I admit it as any proof to the contrary that 
they have at times been visited by this calamity since these 
laws were established, when we know that in some instances at 
least, and probably in all of them, if the truth had been found 
out, the invasion was owing to a violation of these regula- 
tions. 



ITS SYMPTOMS AND PROGNOSIS. 



123 



But whilst I am considering plague as an imported disease, 
and have no doubt on my mind of its being such, I think it 
difficult to account for our own immunity from that scourge for 
such a length of time, without supposing that in part at least it 
may be owing to the care taken abroad to prevent the shipment 
of impested goods, which, indeed, we know to be the fact, or to 
their being expurgated at some of the lazarettos before they 
reach this country. For my own part, I cannot see any other 
good reasons for it. I can never impute our exemption to a 
change in the atmosphere since the malady last appeared, in 
1666, which would prevent it from germinating, were it to be 
imported. I cannot believe this, which is merely an hypothesis, 
unsupported by anything like truth or by analogical reasoning. 
The atmosphere, for anything we know to the contrary, may 
have been changed a hundred times within this century ; but I 
cannot admit that any change of this kind will prevent the con- 
tagion from doing mischief if once it is imported, nor can I 
consider its non-appearance amongst us for such a length of 
time as a sufficient reason for throwing aside the laws of qua- 
rantine, and admitting free intercourse with plague countries. 
Indeed, I am afraid that too much has been said of our long 
exemption from plague, and fallacious reasonings have been 
drawn from thence, which ought never to have been done ; but 
they are not to mislead us, and we must not build our hopes 
of continued immunity on so slender and doubtful a foundation.* 
It is very natural for merchants to wish to remove the re- 
straint on commerce which the laws of quarantine impose ; but 
it is the duty of every government to protect above all things 
the health of a country. Individual interest, supposing such to 
be at stake, must not be put in competition with the public 
safety, and no private considerations, nor bare hypothetical 
reasoning in a case of this kind, ought to have influence. I 

* The risk from imported contagion may be very much diminished, and I 
have no doubt has been so, by the intelligence, activity, and zeal of the Consuls 
residing in countries in which plague is common ; hence the necessity in the 
making these appointments of selecting proper men. 



124 ORIGIN AND HISTORY OF THE PLAGUE; 

cannot suppose for a moment that those who differ from me in 
opinion are actuated by improper motives ; on the contrary, I 
give them full credence for the belief of what they advance. 
My firm persuasion, however, is, that if the laws of quarantine 
were once revoked, the plague, some time or other, would be 
imported, and on being imported, if left to itself, would be as 
fatal in England as it ever was in any other country. 

There is nothing, however, so very singular and uncommon 
in our being exempted from plague for upwards of a century 
and a half. Other places have been exempt from it for a much 
longer period, and have yet got the plague amongst them at 
last; and I confess I am unable to assign any other reason 
for our exemption than the one I have just noticed, rejecting 
such reasons as those of the change of the atmosphere or the 
length of the voyage, unless better evidence is brought to sub- 
stantiate them. If, indeed, it were proved that an impested 
article or articles had been brought to this country without 
having previously undergone any purification, and that such 
were found, after being handled by several persons, to be per- 
fectly harmless, then this, so far as it goes, would be proof that 
the length of the voyage would destroy the contagion of plague. 
But who would be mad enough to put the subject to such a 
test ? Or what government would permit such an experiment 
to be made ? I conclude this subject by affirming that too 
much was known of the dormant and treacherous nature of the 
contagion of plague in Lefchimo to admit of any doubt that it 
may remain active for a considerable time ; and I think it is 
impossible that this infectious principle can be destroyed by 
the voyage alone, without any other means of purification. 

From what has been said of the plague being an imported 
disease, and of the frequency of its having been arrested in 
lazarettos without its doing any further mischief, it will, I trust, 
appear obvious that we have no good reason for supposing that 
this disease, which has so often appeared in England prior to 
1666, was ever generated in this country, or that the usually 



ITS SYMPTOMS AND PROGNOSIS. 



125 



assigned causes of ill-ventilated houses, narrow and filthy 
streets, impoverished living, &c., either separately or conjointly, 
have ever produced, or are capable of themselves of producing, 
this disease. They may cause, and continue disease, I allow ; 
but that disease will not be plague. Moreover, it is well known 
to travellers who have visited other countries and have seen 
these alleged causes existing, (perhaps in a much greater degree 
than they have in England for many centuries past,) that all 
these are not productive of plague. There is something so 
very appalling in the bare supposition that this dreadful disease 
should be capable of capriciously starting up amongst us from 
the existence of any inherent cause, that it is enough to em- 
bitter the comfort and enjoyment of life. There are some, I 
believe, who even at this day are of this opinion ; but I trust 
their number is small, and that their sentiments will have no 
effect on the executive government of this country.* 



CHAPTER X. 

Safest, and perhaps in some circumstances cheapest, to destroy a plague-ship 
at once, rather than to expurgate her — The health of a ship's crew not 
sufficient proof that there is no plague-contagion on board — Indemnifica- 
tion from governments for impested property destroyed — Impossibility 
sometimes of ascertaining at once whether a ship has the plague on board 
or not — Such ship should not be allowed pratique until that point is ascer- 
tained — Manner in which goods may be impested — The plague said not 
to proceed in an easterly direction — Is probably influenced by season — Un- 
certainty of the period plague-contagion may retain its activity — Modifi- 
cation or relaxation of the quarantine laws of England — Why expurgators 
in England have so long escaped the plague — Dealers in old clothes said 
not to contract the plague. 

I am aware that the expurgation of a plague-ship with a cargo 
of goods is a very difficult, tedious, and expensive operation, 

* These reflections were called forth by the opinions delivered before the 
late committee of the House of Commons, appointed to investigate the con- 
tagious nature of plague. 



126 



ORIGIN AND HISTORY OF THE PLAGUE ; 



as well as one not free from danger. But still, in many cases, 
under proper management, and with proper conveniences, it 
may be done. I am nevertheless of opinion, that, generally 
speaking, it will be the best, and perhaps the cheapest way in 
the end, to destroy the ship and cargo at once, and place the 
people under strict quarantine restraint, until their state of 
health is proved to be free from all suspicion, they having first 
undergone the complete spoglio* and washing. 

By doing this, if no communication between the ship and the 
shore has taken place, all danger and risk will be got rid of at 
once ; and as to the people, we must watch progress, examining 
them carefully twice or thrice a day, when, should any one of 
them unfortunately fall sick, he should be instantly separated 
from the rest, which must be done as often as any become in- 
disposed ; and if the disease is confined to the persons in the 
lazaretto, as I am now supposing, after premising that no com- 
munication between the vessel and the shore or any other quarter 
has taken place, I will venture to affirm that this most terrible 
disease will do no harm beyond the precincts of the lazaretto, 
where it will soon become extinct. 

But if, before this arrangement has been made, any intercourse 

* The expurgation, however, of the cargo can only be effectually done in a 
well-arranged lazaretto, where you have persons conversant with that duty. 
As to the vessel, if she is a valuable one, I conceive she need not be destroyed, 
but everything capable of retaining the fomes of plague is to be landed by the 
crew, which, when done, she ought to be frequently fumigated and white- 
washed, having the hatches closed at each time whilst the purification is going on . 
This operation can be very well effected by those of the crew who are in health, 
under the superintendence of the officers of the lazaretto • and they may be 
as well employed in purifying their ship as in passing* their time in the quaran- 
tine not doing anything, and thus save expense, which in any case will be heavy. 

If this has been properly done, I should think that the vessel may be pro- 
nounced to be free from plague, and clean in a month. Thus she is saved, 
whilst the purification of the cargo is going on, when it is decided to be worth 
the expense, risk, and trouble. 

By the complete spoglio, I mean that all the clothes which the persons have 
on are to be taken from them, and should be supplied with others that are 
clean, and they should be well washed with soap and water. Some go so far 
as to shave off the hair, which I conceive to be quite unnecessary. 



ITS SYMPTOMS AND PROGNOSIS. 



127 



has taken place either by smuggling or any other violation of 
the law, the case is quite different, and must be managed ac- 
cording to circumstances, or the general principle so often 
pointed out. 

I have heard that it was the intention, in the first instance, 
to have destroyed the ship and cargo that brought the plague 
to Malta, in 1813, taking the necessary precautions with respect 
to the people on board. But somehow or other this was not 
done. Some goods were landed by stealth from the vessel, and 
very soon after the plague broke out, and followed, as it always 
does, the direct line of communication in the first instance, but 
ultimately became lost in the general intermixture which takes 
place from promiscuous intercourse ; and that this was the 
source of the plague was, I may say, universally credited at 
Malta at the time.* 

I believe there is little doubt that the ship Saint Nicola, from 
Alexandria, brought the plague there, and was the cause of 
that calamity ; and that, had not the laws of quarantine been 
violated during the time that the actual existence of the plague 
on board was doubtful, and before the destruction of the vessel 
could well be resolved upon, (for this is not to be done merely 
on suspicion,) there is no doubt whatever but that island would 
at that time have been spared the ravages of the disease and 
the very serious expenses thereby incurred. 

In speaking of a ship with the plague on board, I am here 
supposing that some part of the cargo contains the fomes of 
plague. It is possible, however, that the cargo might not be 
impested, although the disease had manifested itself among the 
crew. Thus, a shipment might have been made when there 
was no suspicion of plague whatever in the place or neighbour- 
hood for some considerable time before ; the vessel then being- 
ready to sail and her cargo perfectly secured, so that no one could 
have access to it, the cargo would no doubt be free of plague. 
Various circumstances might, however, at this juncture prevent 

* See Notes in Appendix. 



128 ORIGIN AND HISTORY OF THE PLAGUE; 

the sailing of the vessel for a time, until the disease happened to 
break out in the place. The captain or some of the crew, having 
intercourse with the natives, might then bring the disease on 
board, which might not appear till they had been for some days 
at sea ; and should they reach their destined port without the 
integrity of their cargo being interfered with, I should say that 
it cannot be impested. This is, however, an extreme case, and 
although possible, is not probable. Yet, even in this case, if 
it be once ascertained that the plague is actually in the ship, 
the whole must be considered as contaminated, and treated 
accordingly. There can be no modification of the matter — it 
would be drawing too nice a distinction. There are only two 
ways of acting : either to purify the ship and cargo, if they are 
worth the expense and trouble, or to destroy them entirely. 

I may add, by the way, that the health of the persons on 
board is not always sufficient proof that the cargo is perfectly free 
from contagion ; for we can easily conceive that impested goods 
may be shipped, and the crew have no access to them during 
the voyage ; consequently they cannot thereby contract the plague. 

With regard to the remuneration to be granted as a compen- 
sation for destroying ships having the plague on board, or for 
such property as the government may judge it necessary to 
make away with during the time of plague, it is necessary to 
add a few words. 

In order effectually to prevent the introduction of plague 
when ascertained to exist on board ships, as well as the con- 
sequent mischief that would ensue were any communication 
allowed to take place with the shore, the executive government, 
I believe, of more than one country in Europe, has deemed it 
necessary for the public safety to direct that such ships with 
their cargoes should be immediately destroyed ; and sound 
policy, as well as regard to individual sufferers, who might 
otherwise be ruined by this necessary measure, has dictated 
the justice and propriety of granting them some compensation 
for their losses on such an occasion, the amount of which must 



ITS SYMPTOMS AND PROGNOSIS. 



129 



depend on circumstances. In no case, however, have the 
claimants a right to expect full indemnification for their losses ; 
because, supposing it were not decided that the vessel with her 
cargo should be destroyed, but that both were to be purified, 
the expense of such purification in all its branches must neces- 
sarily be defrayed by the proprietors themselves ; and it, gene- 
rally speaking, amounts to a large sum, for so dangerous and 
tedious an operation cannot be undertaken without ample re- 
muneration. The people thus employed are not only to be 
paid during the time the work is going on, but it has been 
usual (although, no doubt, this depends on the original agree- 
ment) to allow them, during the period of the quarantine, which 
they must perform after all their labour is finished, at the rate, 
per diem, of half the sum for which they had originally contracted ; 
besides, some consideration is made them for their clothes, 
supposing they are not provided for them by their employers, 
as in their spoglio they must suffer the garments they had been 
wearing to be destroyed. The probable amount of all these 
expenses must be calculated ; for these would necessarily fall 
on the proprietors in the event of purification, and must be 
deducted from the actual value of the ship and cargo to be 
made away with. It is but fair, also, that the proprietors 
should sustain a part of the loss, even although no blame may 
be attached to them. These deductions, therefore, being made, 
I should imagine, generally speaking, that if one-third of the 
actual value were accorded to the proprietors, it is as much as 
they have any right to expect, and it may be a question, in 
some cases, whether they should get so much, or are fairly 
entitled to receive it. It was according to this calculation that 
compensation was made to the people of Lefchimo for the 
things that were destroyed belonging to them, when the depot 
of impested articles was burned by order of government. 

Could it be positively known a priori that ships arriving from 
plague countries are free from contagion, then there can be no 
doubt that they might be admitted without the necessity of their 



130 



ORIGIN AND HISTORY OF THE PLAGUE ; 



undergoing any quarantine restraint whatever ; but as that point 
cannot be ascertained, or rather, I should say, that as a certain 
degree of suspicion always hangs over a vessel coming from a 
plague country, which is more or less, according to circumstances, 
it would be highly improper to admit such ship to free pratique 
without her having first undergone some purification, or afforded 
proof of health. I am not fully informed of the quarantine regu- 
lations of England, or of the modes of expurgation adopted, but as 
they appear, in conjunction with other circumstances, to have 
been successful in warding off the plague for upwards of a century 
and a half, I think that if any modification is entered upon, it ought 
to be done with great circumspection. I am ready to allow that 
the expurgation of goods brought to this country may often be 
more a matter of precaution than one of absolute necessity ; 
but it would be a very dangerous experiment indeed to remove 
on that account altogether these necessary restrictions. I view 
these restrictions, however, as being of such vital importance, 
both with regard to our own preservation and that of our 
political relation with other countries, that I trust they will not 
be materially altered, at least until there are such conclusive and 
satisfactory reasons, from our more perfect knowledge of this 
subject, as will enable us to do so with impunity. 

As to the manner in which goods may be impested before 
being shipped, it is incumbent also to say something on it. 

Bales, for instance, may be impested both externally and in- 
ternally ; externally, by being handled and carried by con- 
valescents, or by persons having the plague about them ; in- 
ternally, by being packed up by the same class of persons. Nor 
is there anything absurd in the supposition of a person follow- 
ing his usual avocations who is convalescent from plague, or 
may have the plague in so slight a degree as scarcely to inter- 
fere with his daily employments : such occurrences are well 
known to every one who has seen the disease. Indeed, in the 
plague of Lefchimo the convalescents were of the most essential 
service in the expurgation of the houses, and the performance 



ITS SYMPTOMS AND PROGNOSIS. 



131 



of other duties within the district ; and they were often obliged 
to work very hard. Yet every one of them was considered as 
capable of impe sting, and as such was most carefully avoided. 

It is a commonly received opinion (of which I, however, enter- 
tain considerable doubts) that the plague does not extend itself 
in an easterly direction, as it is known to do towards the west ; 
and its ravages in the latter direction, as recorded by authors, 
are much more frequent. Perhaps it is not hazarding too much 
to suppose that there may be a deficiency of information on 
this head, and that the chasm which appears in plague move- 
ments may be attributed to that cause. Certain it is, if we 
credit the accounts of the memorable plague mentioned by 
Procopius, that there is no reason to doubt that it existed in 
eastern countries, and was as fatal there as when it extended to 
the west. If there are any peculiar circumstances capable of 
preventing the disease from extending in an easterly direction, 
I confess I am ignorant of them ; but I know of no reasons as 
far as regards the air, climate, mode of living, or, in short, any 
other cause whatever, why it should not pursue its course in that 
direction, nor have I seen anything, cceteris paribus, like a rational 
ground assigned why it should not travel one way as well as 
the other. It were desirable, however, to be able to ascertain 
whether this prevailing opinion is really well founded or not ; 
whether the supposition I have made be not true in point of 
fact, or whether there may not be explanatory circumstances to 
account for the non-extension of the disease eastward, if the 
fact is really such. 

I am, however, still of opinion that if impested goods are 
packed up, (no matter from what place they come, nor through 
what places they pass, nor whither they are to be carried,) unless 
they are purified by some means or other, they will produce the 
disease wherever they are opened and handled. Nor can I 
conceive that it makes any difference with respect to the interior 
of bales (supposing them to be originally impested) whether 
they are transported by caravans or carried in ships ; nor do I 



132 ORIGIN AND HISTORY OF THE PLAGUE ; 

believe, if these bales are closely packed, as they usually are, 
that any supposed ventilation they could thus receive would be 
a sufficient mode of their purification. 

Although I do not believe that any state of the atmosphere, 
or season of the year, will prevent the development of the 
disease, or stop its extension, yet I do not mean to deny that it 
appears at times to be under the influence of season. In plague 
countries, such as Egypt, which is almost annually, in some 
part or other, subject to this calamity, the disorder generally 
commences towards the end of autumn, and terminates about 
the beginning of summer ; and this with a degree of regularity 
which I conceive cannot well be accounted for otherwise than 
by adopting this supposition. I agree, therefore, with Dr. 
Granville, who thinks " that the seasons have an influence on 
the character of the disorder yet, as I have elsewhere re- 
marked, it is not always the case, for we see that it has started 
and spread at all seasons of the year, and in almost all climates, 
without regarding the extremes of heat or cold. 

But whilst I am of opinion that particular seasons may have 
something to do with the character of the disease, I am disposed 
to attribute its severity to a far more efficient cause, — namely, 
to extensive intercourse with healthy places ; and to this cause 
it is that we are to impute its travelling from country to country, 
and from town to town ; and if we give ourselves the trouble to 
inquire minutely into the matter, we shall, generally speaking, 
be able to trace the road it has taken from its first introduction 
to its present positions ; whilst, at the same time, we shall be 
able to see that where no intercourse has taken place, all round 
remains in the usual state of health. It will effect its ravages 
within this range whilst all without is safe and well. In this 
respect, it resembles very much a conflagration, which if left to 
itself will keep on increasing as it finds fuel and materials to 
support it, with other circumstances favourable to it, and death 
and desolation mark its progress. 

Respecting the length of time during which the matter of 



ITS SYMPTOMS AND PROGNOSIS. 



133 



plague may remain in a state of activity in anything, (supposing 
that no mode of purification has been adopted,) I believe it im- 
possible to decide with certainty whether or not it ever loses 
its contaminating quality if closely confined. This part of the 
subject is extremely obscure, and in the present state of our 
knowledge, I am not aware that anything very satisfactory can 
be adduced either with regard to the effluvia of plague in par- 
ticular, or to infection generally. At all events, we ought to run 
no risk ; for if an article is once supposed to contain the effluvia 
of plague, it ought instantly to be either destroyed or purified 
under the rules of quarantine, when considered worth the 
expense and trouble. 

Viewing, as we have done, the plague as an imported disease, 
and not one generated in this country— considering also that it 
has frequently appeared here in Britain, no matter by what means 
it was introduced, and imputing our immunity from the calamity 
for such a length of time to the active operations of the quaran- 
tine laws, either to their preventing the shipment of impested 
goods abroad, to subsequent expurgation in some of the 
lazarettos in the Mediterranean, or to purification at home — it 
is still, as I have already said, my most decided opinion that 
any material alteration in the quarantine laws of England is a 
subject of such grave and serious importance, and so intimately 
connected with our own preservation, and commercial relations 
with other countries, that I trust no innovation will be made in 
them without the most clear and substantial reasons. 

This is a subject of extreme delicacy, and, in the present 
state of our knowledge with regard to plague, I doubt whether 
any material alteration can be entered upon, without subjecting 
ourselves to a certain degree of suspicion in the estimation of 
other countries. The laws of quarantine, which are those of 
health, are different from all other laws in their operation and 
effects, and are, I may say, general, not partial. They cannot, 
consequently, be interfered with without the suffrages of other 

L 



134 



ORIGIN AND HISTORY OF THE PLAGUE ; 



nations ; else they might place ourselves in quarantine by re- 
fusing to have free intercourse with us.* 

It is not my intention to discuss the merits of this subject 
here, or to say whether some amelioration in the laws of 
quarantine might not be adopted, consistent with our own 
safety and our foreign relations. This is a great national 
question, which must not be hastily decided. 

With regard to the fact (and as far as I know, it is such) that 
the persons who have been employed in expurgating the goods 
brought to England have escaped the plague for such a length 
of time, there may be various reasons (which I allow are 
partly presumptive) to account for it. 

1st. The great attention paid abroad to prevent the shipment 
of impested goods for this country. 

2ndly. Supposing that impested goods had been embarked, the 
contagion may have been destroyed by purification in some of 
the lazarettos in the Mediterranean, where the ships are used to 
perform quarantine before their arrival in this country. 

Srdly and lastly. The contagion of plague may have been em- 
barked in goods, and brought to England ; but by the measures 
of self-preservation enjoined in the lazarettos, or purifying- 
places, the persons employed in purifying them might have 
escaped, it being ascertained that, although the expurgation of 
goods is a dangerous operation, the persons conversant with this 
service may expurgate them effectually so as to destroy the 
contagion, without themselves suffering from the operation. 

It is a commonly received opinion in plague countries, that 
the dealers in old clothes never take the plague, and this is 
mentioned as a conclusive proof of the non-contagious nature 
of the disease. I trust I shall not be considered sceptical if I 
presume to doubt the truth of such an opinion. To suppose 
that they should escape this disease merely because they deal 

* The very report of such an intention produced a lively sensation in some 
of the ports of the Mediterranean, in the year 1825, and subjected our com- 
merce to a temporary inconvenience. 



ITS SYMPTOMS AND PROGNOSIS. 



135 



in old clothes, is too absurd ; for this is the only construction 
which can be put upon it. We know too well that the plague 
is no respecter of persons, and it would be really too much to 
imagine that it respected only the dealers in old clothes. Dr. 
Russell had heard this opinion, but he gave no credit to it ; and 
mentions in page 31 of his work, that in the plague of Aleppo, 
in 1761, it had got among the brokers there, and excited con- 
siderable alarm. For my own part I can have no doubt that 
these men suffer, and in a much greater proportion than other 
persons, from the nature of their trade, unless it can be sup- 
posed for a moment that they possess the most inestimable of 
all secrets, that of preventing themselves from contracting 
plague. Indeed, I cannot conceive how any one can seriously 
believe and assert such a matter as a fact, or how any one can 
be so very credulous as to believe it.* 



CHAPTER XI. 

On the symptoms of the plague — The supposed characteristic symptoms some- 
times absent — Collateral circumstances to be considered in order to enable 
us to decide on its actual existence — Symptoms of the celebrated plague 
mentioned by Procopius — Of that which attacked the British army in 
Egypt — Of that in Lefchimo — Of the prognosis. 

Having briefly considered the history, character, and conse- 
quences of this disease, we are now to consider in a general 
manner its symptoms, and more particularly those that are 
found to be most characteristic of the complaint ; the appearance 
of which, coupled with other circumstances, will enable us to 

* Mr. Green, treasurer to the Levant company, seems to doubt whether the 
plague can be communicated by clothes. On the following question being 
proposed to him by the Committee of the House of Commons, " Have you ever 
known the clothes to be the cause of plague in other persons ?" he replied, " I 
have strong reasons to think that they were not the cause." " Why ?" 
" Because the people who deal in them are not infected." 

L 2 



136 ORIGIN AND HISTORY OF THE PLAGUE ; 

decide on what is plague, and point out, as far as can be done, 
the difference between it and any other prevalent disease ; for 
mistakes in this matter have very often led to the most 
calamitous consequences ; and whatever may in any way tend 
to clear up this matter is a grand desideratum. 

It is to be exceedingly regretted that sometimes, at the 
commencement of this disease, there are not those clear and 
unequivocal symptoms which would enable us to decide with 
the same degree of certainty as in some other complaints. But 
we are not on that account to suppose that at its first evolution 
everything respecting its character and symptoms is loose and 
uncertain, and that we have nothing decisive to guide us, or to 
enable us to form our opinion. This is not the fact ; for to a 
person of discernment, and who has seen the plague, or to one 
who has thoroughly studied its character, there are appearances 
and circumstances almost always connected with this disease 
which cannot well be mistaken. We may not be able all at 
once with certainty to determine whether the cases we are called 
upon to examine be really plague or not, till we inquire mi- 
nutely into all the circumstances — the manner, for instance, of 
the attack, or how the sick were first seized with the disorder ; 
the particular symptoms at that time and subsequently, as well 
as the present ones, endeavouring as far as possible to trace 
the origin of the malady — which, if plague, will be from a certain 
point ; and ascertaining who are ill of the same kind of complaint, 
whether all have not had intercourse with the same suspected 
districts or persons, or whether those who have been subse- 
quently taken ill have not had free intercourse with some 
of the others first taken ill, at the time when no suspicion of 
plague existed ; whether the sickness did not begin at some 
place near the sea ; whether a ship had not arrived from some 
plague country, and had intercourse with that place, either by 
smuggling, or by some other violation of the laws of quarantine, 
prior to the appearance of the sickness ; whether the sickness is 
not almost entirely confined to the persons who have had inter- 



ITS SYMPTOMS AND PROGNOSIS. 



137 



course with one another from the time it was first observed, till 
that when this investigation takes place ; whether a greater 
number of sudden deaths, attended with unusual symptoms 
within the traced chain of communication, have not occurred, 
than among a much larger proportion of the rest of the commu- 
nity ; whether several have not been taken suddenly and violently 
ill, and died off very unexpectedly, some without any particular 
appearances after death, others with spots or petechia on their 
bodies, and subsequently with the buboes or carbuncles, and 
perhaps both, in the same person ; whether the usual remedies 
which it has been thought proper to exhibit in the sickness have 
not appeared to be more unsuccessful than usual, and the disease 
altogether more intractable than generally happens ; whether 
the disease is not observed to be confined to particular families 
within the chain of communication, as already noticed ; whether, 
when the disorder attacked pregnant women, it had not been 
particularly fatal, &c. 

Many of these, and perhaps other inquiries, must be made in 
order to enable us to form our opinion respecting the existence 
of this calamity ; an opinion fraught with the most important 
consequences, and one which, although it ought never to be 
given without due deliberation, and the most perfect conviction 
on either side, yet it is very obvious ought boldly to be given 
if the conviction is that the disease is plague, and orily plague. 
And when once this disease is pronounced to exist, not a 
moment is to be lost in the vigorous application of the proper 
remedies ; for every hour of indecision or inactivity in this state 
of things will be attended with the most serious mischief, by 
allowing the disease to extend itself all around. 

With these preliminary remarks on the collateral circum- 
stances connected with the existence of plague, let us now take 
a view of the symptoms, such as have been recorded by authors, 
and those which came under our own observation in the plagues 
of Egypt and of Corfu. And here it may be mentioned, by the 
way, that although there are always leading symptoms accom- 



138 ORIGIN AND HISTORY OF THE PLAGUE ; 

panying this disease, yet I believe there are no two plagues 
in which the symptoms have been found exactly alike. 

It is here quite unnecessary to enter into a detailed account 
of the various symptoms of plague recorded by authors, as they 
are to be found in their works. I shall therefore confine myself 
to the most remarkable plague mentioned in history, that which 
occurred about the year of our Lord 542, during the reign of 
the Emperor Justinian. 

In the account of this plague given by Procopius, it is de- 
scribed as having emanated from the confines of Egypt, and 
spread itself to the east over Syria, Persia, and the Indies ; 
to the west, along the coast of Africa, and over the Continent 
of Europe. The symptoms were ushered in by the visions of a 
distempered fancy in a manner that was not previously known ; 
and the people were attacked in their beds, in the streets, and 
in the midst of their usual occupations. It was attended with 
fever, and accompanied with buboes in the groin, arm-pits, and 
under the ear. If these suppurated kindly, the patient was saved, 
but if they continued hard and dry, mortification came on, and 
the patient died about the fifth day. The fever was commonly 
accompanied with delirium or lethargy. The bodies of the sick 
were covered with black pustules, or carbuncles, the symptoms 
of immediate death. To women pregnant, the disease was 
generally fatal. Every rank and profession was attacked with 
indiscriminate rage. In Constantinople, although the physicians 
were zealous and skilful, their art was baffled by this vehement 
disease. It was the opinion of the citizens, from short partial 
experience, that the disease could not be gained by the closest 
conversation. It spread from the sea-coast to the inland 
countries, &c. 

In reviewing the preceding account of this most memorable 
plague, it is worth remarking, 

1st. That it seems to have been the prevailing opinion in all 
ages that the plague originated in Egypt, or in the countries 
bordering upon it. 



ITS SYMPTOMS AND PROGNOSIS. 



139 



2nd. That from thence it travelled by unrestrained intercourse 
and by means of emigration, warfare, or trade, to other parts 
even in an easterly direction. 

3rd. That it spared neither age, sex, rank, nor profession. 

4th. That the bodies of the sick exhibited the appearance of 
black spots and carbuncles, which were considered the unerring- 
harbingers of death.* 

5th. That those whose buboes suppurated kindly were 
saved ; whilst those in whom they continued indolent and hard, 
died about the fifth day. 

6th. That it was peculiarly fatal to pregnant women. 

7th. That the medical art was baffled by the overwhelming- 
calamity. 

8th. That it spread from the sea-coast towards the inland 
country, but that ultimately the remotest places were not secured 
from its ravages. 

On referring to my notes on the plague of Egypt, which 
attacked the Indian army, to which I was attached at the time, 
I find there was always more or less fever. Great prostration 
of strength was a common symptom, also headach attended 
with giddiness, more or less stupor, and coma ; pulse variable, 
sometimes small and fluttering, at others full and hard ; the 
lips appeared to be of a livid colour, with a shrinking of the 
features ; often a sensation of cold and chilliness extending 
along the spine ; tongue generally whitish and streaked ; 
appetite from the beginning much impaired. In addition to 
these symptoms, I observed a considerable degree of pectoral 
affection, which was perhaps owing to the cold, which at that 
time was pretty severe, and which the natives of India seemed to 
feel much. These symptoms seemed to mark the first stage of 
the disease. It was also often ushered in with violent vomiting, 
sometimes of a dark, sometimes of a yellow matter, and now 

* Probably the author here means vibices, which are almost always the fore- 
runners of death ; at least, in modern plagues, carbuncles are not found to be 
quite so deadly a symptom. 



140 ORIGIN AND HISTORY OF THE PLAGUE; 

and then with rigors. Some of the patients, too, were carried off 
within from 16 to 24 hours after they first began to complain. 

By and by, the symptoms increase with more or less rapidity 
and violence, and the affection of the head becomes so severe, 
that the patient is unable to raise it up. The prostration of 
strength is also so great, that in some cases he is scarcely able 
to walk about, or even stand upright. He has no inclination 
to make the least exertion, unless compelled to do so. He sleeps 
little, and that little seems to render him worse. He starts in 
his sleep ; has frightful dreams, with a low muttering delirium. 

Buboes soon make their appearance. The degree of coma 
and stupor is sometimes so great, that the patient does not seem 
to understand, or take the least notice of what is said to him. 
There was also a remarkable dryness of the skin amongst those 
natives of India whom I attended, which no sudorific that was 
tried could remove ; a peculiar appearance of the countenance, 
approaching to risus sardonicus, with a wildness in the eyes, 
which indicated a disturbed state of the sensorium : nor were 
involuntary evacuations an unfreque'nt symptom.* 

Having briefly stated the more common symptoms which I 
observed among the Indian troops, a more particular account 
of which is to be seen in Sir James McGrigor's Medical 
Sketches, I now turn to the consideration of the same subject in 
the plague of Corfu. And here I must premise that, as I did 
not arrive thither from Genoa, where I was serving with the 
army of the Mediterranean, until after the violence of the disease 
was over, my information is chiefly drawn froin the report of 
the medical officers who were serving in the impested district 
before my arrival, and who, with one exception, continued in 
the execution of their respective duties there, until free pra- 
tique was proclaimed between that district and the rest of the 
island. 

* I do not find petechia' or vibices mentioned. This possibly was from not 
observing them on the dark skins of the Indians. 1 remarked, also, great 
flexibility of the body after death. 



ITS SYMPTOMS AND PROGNOSIS 



141 



The medical officers were chiefly from our own army, but 
there were also several Greek doctors, and one Frenchman, 
who had been a surgeon in the French army. Of the Greek 
doctors, Dr. de Georgio was employed in the lazaretto attending 
the sick. 

The symptoms of the plague in Corfu, as collected from the 
medical officers employed on that occasion, were as follow : — 

More or less fever, sometimes of a remittent, sometimes of an 
intermittent type ; great prostration of strength ; staggering like 
a drunken man ; often violent headach ; tremors ; derangement 
of the stomach, with a sensation of burning heat ; vomiting, 
sometimes of a yellow, at others of a blackish matter, like 
coffee-grounds ; involuntary evacuations, both of urine and faeces 
at times, when the patients did not appear to be very ill, and 
which seemed the effect of fear, stupor, coma ; often violent and 
sudden exacerbations of fever, which could not be said to belong- 
to any type ; a white, glossy tongue, the edges of which were 
generally clean, with a streak in the middle. The countenance 
exhibited an appearance of terror mixed with anxiety, and, as 
it were, claiming pity, which it is difficult to describe, but which 
is well known to those who see plague patients, and is very 
characteristic of the disease* Sometimes the disease was 
ushered in with furious delirium, approaching to a state of 
phrenitis, with the eyes, as it were, ready to start from their 
sockets, and the face flushed, as if mad with the effects of drink 
and passion, so that for a time they became quite unmanage- 
able. The duration of the paroxysm sometimes lasted for 
hours, after which they became calm and composed, and in 
some instances appeared to be quite rational. In some cases, 
these violent exacerbations were succeeded by cold rigors; 
these alternated, and the unhappy sufferer was carried off by 
them, sometimes without exhibiting those eruptions which are 
supposed necessary to form the character of plague. 

Buboes and carbuncles were very common symptoms, par- 
ticularly after the first ebullition of the disease was over. When 



142 ORIGIN AND HISTORY OF THE PLAGUE ; 

they came to suppuration, it was considered favourable ; but in 
the cases in which this could not be effected, and where they 
continued indolent and painful, with much fever, dryness, and 
heat of the skin, they almost always brought the disease to a 
fatal termination. Some few of the buboes were dispersed by 
resolution, and the patients did well. These, however, were 
not frequent ; for of all the patients with buboes who entered 
the lazaretto near the Casapoliti, only five recovered, whose 
buboes were discussed. Those whose buboes continued hard 
and painful generally died. In them, the powers of nature 
seemed unequal to the task of bringing on suppuration, and the 
patients sank under the disease. 

Dr. Russell remarks, p. 112 : " Their presence (viz., that of 
buboes and carbuncles), separately or in conjunction, leaves 
the nature of the distemper unequivocal. But fatal has been 
the error of rashly, from their absence, pronouncing a distemper 
not to be the plague, which in the sequel has depopulated 
regions, and which early precaution might probably have pre- 
vented from spreading." Sometimes these buboes were ex- 
quisitely painful, and of a deep red colour ; at other times, they 
were attended with very little pain, and no discoloration. I 
may remark, with reference to the symptom of staggering, that 
it caused me considerable alarm, soon after my arrival in the 
plague district, as the following anecdote will show. 

My Italian servant, Guiseppe, whom I supposed to be a sober, 
steady, trustworthy man, happened to get very drunk one day 
whilst I was out at my inspections. When I returned, I found 
him nearly insensible in his tent, and everything in my own 
topsy-turvy. I ordered him to get up, that I might see what 
was the matter with him, and taxed him with being drunk, 
which he denied. I began then to suspect that somehow or 
other he had got the plague, and that I myself had every chance 
of getting it from him — no very pleasant subject for contempla- 
tion. I immediately called one of my guard, and desired him 
on no account to permit him to leave his tent. My own feelings 



ITS SYMPTOMS AND PROGNOSIS. 



143 



were not very enviable at this moment, as he was the only 
servant I could have under present circumstances, and I had 
taken him with me from Genoa, at the recommendation of my 
brother, whose servant he had been before. Moreover, from his 
attachment to me, he had volunteered to accompany me on this 
service. It was too late to do anything with him for that night, 
and I went to bed with all the horrors of plague about me, and 
of course could not sleep. The next morning, at daybreak, I 
went to see him, and found that he had not awoke. In a few 
hours after, he got up to prepare my breakfast, and was much 
surprised to find that the sentinel would not allow him to go 
into my tent. I went to see him, and found him labouring under 
all the symptoms of his last night's debauch, which he now 
confessed, assuring me that he had been in no place where he 
could get the plague. I kept him, however, under the eye of 
the guard, whom I desired not to have any communication with 
him for a couple of days, when, being satisfied there was no 
plague in the case, he was liberated. I impressed on his mind 
in the strongest manner the necessity of his having no inter- 
course with any one, else he might get the plague, and would 
be sent to the pest-hospital. This lecture alarmed him, and I 
never had occasion to find fault with him afterwards. 

Petechia and vibices were common in the beginning of the 
disorder, as well as during the whole time of its continuance, 
and were the unerring messengers of death, as seldom twenty- 
four hours elapsed from the time they made their appearance 
till death closed the scene. The unfortunate sufferers seemed, 
as it were, to drop into the grave without the power or even 
the inclination to help themselves ; whilst, in some instances, 
they seemed quite conscious of their approaching fate, and 
life in them became extinct almost without a struggle. 

In some instances, the blood seemed to be in a dissolved 
state, producing epistuxis and other haemorrhages as from the 
stomach and bowels. 

Such was the furious delirium in some cases, that the unhappy 



144 ORIGIN AND HISTORY OF THE PLAGUE; 

persons were with great difficulty earned to the pest-hospital ; 
whilst others, with unequivocal symptoms of plague, had such 
a dread of being carried on the bearers, or even touched by the 
persons appointed to transport them to the hospital, that they 
entreated they might be allowed to go by themselves, and not 
be interfered with by the condannati. In some cases, this exer- 
tion no doubt aggravated the symptoms. 

In certain instances, when the disease was ushered in by a 
violent degree of fever and affection of the head, the patient 
seemed almost all at once to be relieved from his dread of the 
disease, became tranquil and collected, and even laughed at 
the idea of his having the plague ; would call for wine, and 
drink it off with apparent avidity, for the purpose of deceiving 
both himself and others. By and by, buboes, or carbuncles, 
began to make their appearance ; the delirium and fever re- 
turned, and the wretched sufferer died without either the one 
or the other having come to suppuration ; or the -petechias, ap- 
peared, and closed the scene. On some occasions, the thread 
of life was cut short without any of these appearances, the 
patient being suddenly carried off in these struggles. The fol- 
lowing anecdote was mentioned to me by Mr. Sammut, as- 
sistant-surgeon of the Corsican rangers, who served with me in 
the plague of Corfu. 

A poor woman of Saint Theodoro, shortly after the plague 
broke out there, when first attacked, became furiously mad, and 
ran about the village in her shift. Her husband was unable to 
restrain her ; and no one dared to approach her. At length, 
one of the neighbours, a strong active man, on his being pro- 
mised a sum of money, some oil, and other presents, agreed to 
assist the husband in securing the unfortunate creature, and to 
conduct her to the hospital in the town of Saint Theodoro, 
there being none of the servants at hand at the time. This 
being done, she died there the next day with buboes. In a day 
or two after, the husband fell ill, and was sent also to the hos- 
pital, where he died after an illness of two days with the buboes. 



ITS SYMPTOMS AND PROGNOSIS. 



145 



The man who, for the sake of the money and other presents, 
had volunteered his service in this business, as yet continued in 
health, and was quite pleased at being so well rewarded for so 
very little trouble, though annoyed at not being permitted to 
return to his family, on account of his intercourse with impested 
persons. Unable, therefore, to join his family, he consented to 
remain as an hospital attendant, on the promise of being well 
paid for his trouble. He was only four days in his new em- 
ployment when he complained of headach, staggering, prostra- 
tion of strength, with other symptoms of the disorder, and died. 

A confused feeling in the head, anxiety, and a hurried and 
abrupt manner of speaking and answering questions, were 
symptoms often present. 

Failure of the voice was a common symptom, and probably 
depended on the great debility. A peculiar muddy or glassy 
appearance of the eyes was also very frequent. 

Loss of appetite, as may be supposed from the tumult in the 
system, was an accompanying symptom of plague ; but this 
was not universal. 

Mr. Sammut mentioned to me the case of a poor child ill of 
plague, who exrjressed a wish to eat some cake made with eggs 
and flour, which was got ready for him. He ate some of it 
with apparent eagerness, and called for more, which was also 
given him ; but whilst this second portion was in his mouth, he 
fell backwards and expired. 

The pleuritic affection, which was so remarkable among my 
plague cases in Egypt, was not a frequent occurrence here. 

Diarrhoea was sometimes an accompanying symptom of 
plague, caused probably by the deranged state of the stomach 
and bowels. It was difficult to manage, and frequently con- 
tinued to the last. 

Morbid dryness of the skin was common in Corfu, as well as 
in Egypt ; but it was not so universal nor so obstinate as in the 
latter. On the contrary, many patients during the violent 
paroxysms sweated profusely, and when sudorific medicines 



146 



ORIGIN AND HISTORY OF THE PLAGUE ; 



were exhibited, the skin often became moist. Yet the symp- 
toms were not thereby relieved so generally as we are accus- 
tomed to see in cases of common fever. 

A discharge from the urethra, similar to that in gonorrhoea, 
was also noticed. A man was reported to Mr. Sammut as 
having a swelling in his groin, which is an alarming symptom 
in the time of plague. He went to see him, and found, in 
addition to the swelling in the groin, he had a discharge from 
the urethra. In other respects, he appeared to be in health ; 
and when questioned as to his having had any suspicious con- 
nexion, answered in the affirmative, and that he believed the 
complaint was owing to that. He was not of course ordered to 
the hospital, but Mr. Sammut continued to visit him at his house. 
In a short time, the unequivocal symptoms of plague came on ; 
he was then sent to the hospital, where he died in a few days.* 

In some cases, the thirst was intolerable, which nothing could 
quench or alleviate . In others, this symptom was not at all 
remarkable. 

In several patients, there was a constant watchfulness and 
restlessness till death ; and in some of those who recovered, it 
was often a long time before they enjoyed natural and re- 
freshing sleep. In the cases where sound composing sleep was 
enjoyed, it was considered favourable. 

Some of the patients complained of a burning heat all over 
them. 

It was truly distressing to observe the rapidity with which 
a family, or the different persons in a tent, dropped into the 
grave, one after another, which nothing could prevent. 

Soon after the malady broke out in Saint Theodoro, a family 
of the name of Curri was attacked, consisting of nine persons, of 
whom eight died of the plague, whilst the ninth, a boy only five 

* The account he gave might have been true, or it might have been to 
deceive the medical officer, for fear of being sent to the hospital ; none but prac- 
tical men can know the deceptions that are used in times of plague. 



ITS SYMPTOMS AND PROGNOSIS. 



147 



years old, escaped. A woman, from motives of compassion, 
took the poor child out of the house, in which were the dead 
and the dying; she also escaped. 

Nor was it less painful to remark with what singular violence 
this most unrelenting enemy of human life attacked preg- 
nant women — thus, as it were, striking at the very root of 
existence in the destruction of the unhappy mother and her 
offspring. The abortion was almost always preceded by haemor- 
rhage, which continued after that event had taken place, and the 
mother sank almost immediately under the consequent debility. 
Petechia frequently appeared among these women, but very 
rarely buboes. Yet sometimes the body did not exhibit any 
eruptive appearances whatever, and it became a doubt whether 
the woman did not die of the haemorrhage, unconnected with 
plague ; and I am persuaded that this supposition, when it led 
to the neglect of the necessary precautions, was attended with 
serious mischief. In one family in Lefchimo, considered 
healthy, the mother had an abortion and died suddenly, without 
her complaint being thought to be plague. The disease, how- 
ever, soon manifested itself in the family, and one or two died. 
If immediate separation had taken place when the woman was 
taken ill, possibly the family might have escaped; at least, it 
was their only chance. 

Although abortion, generally speaking, gives a more severe 
shock to the female constitution than a natural labour, even 
when attended with some untoward circumstances, yet it rarely 
happens that women die immediately of the discharge. I have 
known a serious haemorrhage in a delicate lady which would 
have endangered the life of the most robust man, and yet this 
lady soon recovered, and did well. 

It is remarked, that in cases of abortion occurring from 
plague, the woman will sink under a trifling discharge, which, 
under other circumstances, would be productive of little or no 
inconvenience. It was so fatal in the plague of Corfu, that 1 



148 ORIGIN AND HISTORY OF THE PLAGUE ; 

never heard of one who survived it. Both the mother and the 
child died.* 

Yet this disease, so violent and destructive in some instances, 
was in others veiy mild ; nothing particular, but a simple buboe 
or carbuncle, without any other peculiarly marked symptoms. 
Such cases were most common towards the decline of the 
disease. 

Anastasio Caragiopolo, sixty-six years of age, inhabitant of 
the village of Anaplades, but then in the camp of high suspicion, 
was taken ill on the evening of the 16th of May, and was one 
of the last cases that occurred. He had been for some time in 
the camp, and several cases of plague had been sent to the 
hospital from his tent. The day he was taken ill was the eighth 
from the last accident there, and he had been careful in airing 
and handling his effects, keeping himself clean, and bathing in 
the sea. 

When he was first taken ill, he complained of slight head- 
ach, and said he felt generally unwell, but did not name any 
other particular symptom. Although, as I said, eight days had 
elapsed from the last case of plague in his tent, it was clear 
that it could not be positively said that he might not have the 
plague. Yet his indisposition appeared to be so slight, that it 
was only supposed to proceed from a cold. Some purgative 
medicines were given to him, which relieved his head, and he 
said he felt better. 

I saw him on the morning of the 18th, and was informed he 
had passed an indifferent night. On his coming out of the tent to 
speak with me, I perceived that he staggered like a drunken man, 
a symptom too well known. He had a failure of the voice, great 
prostration of strength, that peculiar appearance of countenance 
and eyes already described, with a white tongue and an incipient 
bubo in the right groin, which he said was free from pain ; 

* We had several pregnant women in the camps of observation, some of 
whom had their accouchement there, and with their infants did well. 



ITS SYMPTOMS AND PROGNOSIS. 



149 



and pressed it roughly with his hand, to show me that it was 
not painful. He seemed to be quite collected, and answered 
distinctly the questions put to him. I was informed that he had 
been employed before my arrival in making his last will. As 
this was a decided case of plague, he was immediately ordered 
to the hospital, which was only 200 yards distant, and he walked 
thither without much difficulty. He died next day, covered 
with jjetechice* 

Another frequent and unfavourable symptom was a singular 
apathy and indifference even to the most powerful calls of 
interest and natural affection, from which nothing could rouse 
them. This symptom is mentioned, I believe, by Assilini, in 
his account of the plague which attacked the French army in 
Egypt. 

Having mentioned the leading symptoms in the memorable 
plague during the reign of the Emperor Justinian, giving a short 
account of the disease as it showed itself in Egypt, and detailed 
the general and most remarkable symptoms under which it 
appeared in Corfu, I trust in so clear and distinct a manner as 
to enable persons of observation to discriminate betwixt the 
plague and other diseases, I have only further to add on this 
part of the subject, that whenever the train of symptoms which 
I have described occurs, conjoined with the additional circum- 
stances noticed, we can have no hesitation in pronouncing the 
disease, whatever it may be designated by some, to be plague 
alone, and thus we shall avoid falling into that most fatal error 
of mistaking it for another disorder ; an occurrence which, I am 
afraid, has happened more than once, and led to the most cala- 
mitous and dreadful consequences in the omission or procrasti- 
nation of those remedies which can alone suppress it. But 
before we come to a positive decision on this very important 
matter, and pronounce the actual existence of plague, a report 
pregnant with such mighty consequences, and which, for a time 

* This case, with some additional particulars, is detailed in the Appendix, 
(Case XXVI.) 

M 



150 ORIGIN AND HISTORY OF THE PLAGUE; 

at least, will render it necessary to cut asunder the ties of all 
social enjoyment, both civil and religious, it behoves us to look 
well into the case, and examine minutely all the symptoms and 
concomitant circumstances ; for whilst it would be highly crimi- 
nal to conceal the plague one moment after its existence is 
ascertained, so it would be dreadful to spread any such rejDort 
or alarm without a perfect conviction of its reality. 

The prognosis in plague is always unfavourable, but some 
estimate may be formed of the favourable or unfavourable termi- 
nation of the disease from the moderate or violent nature of the 
febrile symptoms and external appearances. 

Haemorrhages, from whatever parts they come, are generally 
fatal. Dr. De Georgio, in his report, says only one of seventeen 
patients who had this symptom recovered. Petechia and vibices 
are almost invariably the immediate forerunners of death. In 
the plague of Corfu, I could not learn that any person, either 
male or female, who had these eruptions, ever recovered. When 
the buboes were hard and indolent, and the skin not discoloured, 
it was considered unfavourable, especially if accompanied with 
a hot dry skin. When the skin was moist, the fever moderate, 
and the buboes showed a disposition to suppurate, it was con- 
sidered favourable. But sometimes even in these cases fatal 
symptoms intervened, and the patient dropped off when it was 
least expected. When, however, the bubo suppurated kindly, 
with moderate fever, and the patient survived till after the fifth 
day, in general the case did well. 

Dr. De Georgio, in his report, mentions that buboes in the 
parotid and submaxillary glands, as well as those behind the ear 
and in the neck, were generally fatal, and that those in the axilla 
were more dangerous than those in the groin. 



ITS SYMPTOMS AND PROGNOSIS. 



151 



CHAPTER XII. 

On re-infection and relapse. 

I have already noticed that several of the convalescents from 
plague volunteered their services as expurgators, and although 
the men thus employed were from necessity continually exposed 
to the influence of contagion by handling and carrying the 
impested things, yet neither any of them, nor indeed any of 
the convalescents, suffered from re-infection, and certainly none 
could be well more exposed to the contagion than the former 
were, independent of the great fatigue, the extreme hot weather, 
and the privations which they every day suffered. I am there- 
fore fortified in the opinion, which is indeed almost universally 
received, that patients who have once passed through the 
disease are in little danger from a second attack that season, 
and perhaps less susceptible after a lapse of years than they 
had been before they were attacked. 

With regard to the terms re-infection and relapse, there appears 
to have been some confusion, caused by using indifferently the 
one for the other, though they are distinctly different. I would 
define re-infection to be a return of the disease some time after 
the patient had been completely cured, that is, with the sores 
healed, and the febrile symptoms completely gone. Should 
such person be again exposed to the contagion, and again 
contract the disease, he has a fresh attack, and this is re-in- 
fection. 

I take the term relapse in the acceptation in which it is 
given in the Traite de la Peste — "Ce que Ton doit propre- 
ment appeller rechute, est la suite d'un mal, qui n'a pas ete 
bien gueri; et qui se renouvelle par un reste de malignite, que 

M 2 



152 ORIGIN AND HISTORY OF THE FLAGUE j 

les remedes, les precautions, et le terns, n'ont pas entierement 
detruit." 

In illustration of this definition, which appears to me a very 
just one, I would mention the case of Jacometto Lavrano,* 
belonging to Clomo ; the first case mentioned under the charge 
of Mr. Saisset which bears directly on this point. This 
gentleman, in his conversations with me on the subject, seemed 
to consider these relapses, or rather the breaking out of fresh 
symptoms, as so many reinfections, or, as he termed them, fresh 
attacks, although I think it is quite evident that the patient was 
all along labouring under unequivocal symptoms of the disease 
from the first infection, which was attacking one part after 
another, and he seemed to me to mistake these accessory 
symptoms for signs of reinfections. 

In fevers, do we not see that patients, whose convalescence is 
pretty well established, fall back, and this oftener than once, 
from various irregularities, and other causes, which it is not 
necessary here to enter upon ? Such occurrences are termed 
relapses, and not fresh attacks of the fever, because the patient 
has never been thoroughly well ; whilst, on the other hand, if 
he has been perfectly cured for a considerable length of time, 
a return of the disease would be correctly denominated a fresh 
attach. I am aware that some fevers, particularly those of the 
intermittent and remittent type, not unfrequently leave a dispo- 
sition in the system to return after a very considerable lapse of 
time ; and this disposition is so well known to exist in some 
persons who have had the ague, that for many years after they 
have had it, they feel unwell at that particular season of the 
year at which they contracted it, and seem to be remark- 
ably susceptible to the state of the weather about that time. 
Yet I apprehend the plague leaves no such disposition behind 
it. I myself have known several persons, who have safely 
passed through this disease, some of whom had it many years 
ago, and from all the information I could collect from them, 
* Vide Appendix. 



ITS SYMPTOMS AND PROGNOSIS. 



153 



their state of health was, and had been, as perfect as it ever 
was before, and they never felt at an after period anything 
which they could fairly attribute to that cause. Such cases, 
however, as the private of De Rolle's regiment, already noticed, 
or where there has been any permanent organic affection, must 
of course form exceptions ; but happily these occurrences are 
very rare. 



PART III. 



NARRATIVE OF THE PLAGUE OF LEFCHIMO ; ITS 
INTRODUCTION AND PROGRESS. 

CHAPTER I. 

Short account of the plague district — Subject to autumnal remittent fevers — 
Introduction of the plague into Lefchimo. 

Before entering on the narrative of the plague which raged in 
the district of Lefchimo, in the island of Corfu, towards the latter 
end of 1815, and till its final suppression in the month of May of 
the following year, it may be proper to give a short account of 
the local situation of the district, and of the manner in which 
the calamity was introduced into it. 

The imp ested district comprehended all the lower and southern 
part of the island, from Messongie, close to the Casa Alamanno, 
where the principal cordon was established, and which extended 
along the banks of a river almost from sea to sea ; so that 
this military line completely cut off Lefchimo from the rest of 
the island. This tract of country is about 40 miles in circum- 
ference, and in the upper part, or district,* is a good deal varied 
by hill and dale. Some places are close and woody, and covered 

* By the upper part of the district — an expression which I shall have fre- 
quently occasion to use — I mean the whole tract of country between both seas, 
extending in a south-easterly direction from Casa Alamanno to Casa Politi, and 
from thence across the country in an oblique line to Critica on the opposite 
coast. By the lower part is meant the whole remaining south-eastern ex- 
tremity of the island. 



NARRATIVE OF THE PLAGUE OF LEFCHIMO, ETC. 155 

with olive plantations or copsewood. Part is cultivated as vine- 
yards and corn-fields, but by far the greatest portion is in a wild 
state. It is much intersected with rivulets, which in the summer 
are often quite dry. The roads are extremely bad, and indeed 
they scarcely deserve the name. In winter, when the ground is 
soft and boggy, they are almost impassable. Over this extensive 
tract of country, twenty-seven villages or towns, besides a con- 
siderable number of detached houses, are scattered. Of these 
towns or villages, fourteen had been attacked by the plague. 
And although measures had been taken for extirpating the 
malady before my arrival, it could not be known, from the 
desultory manner in which the plague had started up in several 
places some short time before, how far the disorder might be 
considered as suppressed in other places. 

To the close, swampy situation of the district must be attri- 
buted the frequent appearance of an autumnal remittent fever 
of a bad type ; and it is probably owing to this that when the 
plague first broke out it was considered to be only a return of 
the epidemic. 

I was informed by Dr. De Georgio, who was in the imme- 
diate charge of the pest-patients, and who had practised as a 
professional man in the district for five years preceding 1815, 
when the plague broke out there, that during all that time, in 
the course of his practice, he had occasion to treat between two 
and three hundred of these cases ; but he does not remember 
ever to have seen any of his patients with buboes, nor those 
particularly marked symptoms which he saw afterwards among 
his plague-patients. 

In investigating the manner in which the malady was intro- 
duced, much pains were taken by myself and the other medical 
officers during our residence within the district. Some obstacles 
were thrown in the way of inquiry by those who wished to 
screen their friends, who were strongly suspected of being con- 
cerned in the business. The result of all our inquiries, how- 
ever, fixed its introduction on a smuggling vessel, commanded 



156 



NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 



by a Captain Gerasimo Spirachi, from the opposite coast of 
Albania, which disembarked her cargo at the magazine on the 
shore, close to the CasaPoliti, (see the map,) to which the things 
were carried and opened afterwards.* 

It was ascertained, through the diligence of Assistant-Surgeon 
Gemmellaro, of De Rolle's regiment, serving under my orders, 
that some cases, or bales of goods of some kind, had been 
secretly landed from the vessel, and carried up to that particular 
house ; that soon after they were opened, the family and ser- 
vants began to fall sick, and some of them to die suddenly. 

This was declared upon oath, according to the solemn and 
impressive manner prescribed by the rites of the Greek church, 
by a servant-girl belonging to the house, then a convalescent 
from plague, in the hospital. This girl mentioned, that soon 
after the sickness broke out, she fell very ill, and continued so 
for a long time ; and I am persuaded that it was so, for she 
showed me the cicatrix of a carbuncle on her breast, which was 
at least five inches in circumference. She remembered seeing 
the things brought up to the house, and that soon after the 
family became sick. She was by no means willing to give this 
account, from an apprehension that it might bring her master 
into trouble. 

The account this young woman gave was in all the essential 
points confirmed by the testimony of other respectable wit- 
nesses, so that I have no reason whatever to question her state- 
ment, which I believe I may say was credited all over the district, 

I ought not to deny that there were some reports in circula- 
tion differing from the account which I have just given ; but I 
could trace them to no satisfactory sources. 

On further inquiry into the matter on my return to the city, 
after my liberation from the plague -district, I learned that a 

* As to the captain or his vessel afterwards, I was never able to obtain any 
satisfactory information. But I do not wonder at his keeping out of the way, 
aware as he must have been of the punishment he deserved as a smuggler, 
and which no doubt would have been inflicted on him to the full extent had 
he ever made his appearance. 



ITS INTRODUCTION AND PROGRESS. 



157 



brother of her master, Signor Politi, stung with remorse at 
having been concerned in the introduction of this calamity, had 
destroyed himself; and that long before the breaking out of 
the malady, the Politis had been suspected of favouring con- 
traband traffic, and were, in fact, smugglers. 

It was currently reported in the district, and also generally 
believed, that among the smuggled things which were sent for 
sale to the village of Marathea, there was a parcel of red caps, 
articles which the Greeks are accustomed to wear, and it was 
after these caps had been sold in Marathea that the disease 
appeared there ; and to these caps was the introduction of the 
disease there attributed. 

It was in tins village that the malady first excited the public 
attention ; and I learned that a report from the justice of peace 
in the district, about the 18th of December, on the subject of 
the sickness which prevailed there, was the first intimation 
which the government had of the matter, and this was some 
time after the malady had broken out, and when, in fact, it was 
general in the village. Up to this time, the sickness in the 
Casa Politi seems to have been carefully concealed. 

I was never able to ascertain with certainty whether the 
disease first appeared in the Casa Politi, or at Marathea ; but I 
learned from undoubted authority, and by comparing the dates, 
that it appeared about the same time in both places, and excited 
alarm in each of them by the violence of the symptoms and 
the sudden deaths. 

I understood also, on further inquiry, that shortly before the 
disease was known to exist at the Casa Politi, several of the vil- 
lagers belonging to Marathea had been employed in working 
there ; and after their day's work was ended, they used to return in 
the evening to the village, by which means a constant inter- 
course existed betwixt the two j)laces ; and although I inquired 
very particularly into the matter, I was unable to discover that 
any of the inhabitants belonging to the other villages had been 
there about that time. 



158 



NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 



CHAPTER II. 

Propagation of the calamity in the upper district — First in the village of 
Marathea — Mr. Tully sent to inquire into the sickness prevailing there — 
Did not consider it to be the plague — Measures of restraint entered upon — 
The sickness superstitiously imputed to an evil spirit — Propagated by the 
priests in the villages of Perivoli and Anaplades — In Argirades — Troops 
sent into the district — Also medical officers — Melancholy occurrence 
among the troops from a violation of quarantine — Propagation of the 
calamity in the village of Rumanades — In Neocori — In Cuspades — In 
Clomo — Another distressing occurrence among the troops from a violation 
of quarantine — Saint Dimitri impested — Also Critica — The other villages 
of Upper Lefchimo not impested — Necessity of some restraint in places 
not impested — Want of confidence necessarily existing in the time of plague. 

Among the villagers belonging to Marathea who had been em- 
ployed on the occasion mentioned at the Casa Politi, were some 
persons belonging to the family of a man named Marco 
Masaracci, and I ascertained in the most satisfactory manner 
that the malady first appeared in this man's house. The first 
person attacked by it was one of his sons, a boy four years old, 
named Spiro Masaracci ; and on the same day, a young woman, 
the daughter of one Nicomani, who had slept with the boy. 
This young woman, it appears, had a swelling in her neck, and 
another in her groin ; and both died after three days' illness. 
For two days after, nothing further occurred in the family ; but 
on the third, another son, who had been out shooting, fell ill, 
and died on the fifth day after he was attacked ; he had a bubo 
in his groin. The distracted parents, after carrying their son 
to the church to be buried, found, on their return home, a female 
infant, only fourteen months old, very ill of what they took to 
be a kind of fit, which carried her off in a few hours. 

After this, Masaracci's wife was attacked and died, after an 
illness of seven days, during which she had the most furious 
delirium at times and irregular exacerbations of fever. She 
complained of dreadful headach, had violent rigors, in one of 



ITS INTRODUCTION AND PROGRESS. 



159 



which she expired ; and two days after, her husband also was 
carried off with nearly the same violent symptoms. 

A few days after this melancholy destruction of Masaracci's 
family, his brother, Nicola Masaracci, was attacked with a high 
degree of fever ; he had two inguinal buboes, and died on the 
fifth day. 

Almost at the same time, the son of this man, and afterwards 
his wife, Stamatella, fell sick and died ; both had buboes. 

These occurrences took place, and, as I was informed, six- 
teen persons died, before any report on the subject was sent to 
Corfu. 

On the receipt of the official communication from the justice 
of the peace in the district relative to the sickness in Marathea, 
his Excellency Lieut.-Gen. Campbell, then the King's Commis- 
sioner, directed an inquiry to be made into the matter ; and 
Mr. Tully, who was at that time president of the board of 
health and the senior medical staff-officer, accompanied by two 
of the principal physicians of the island, were sent down to in- 
vestigate the affair, and report on the subject. 

It appeared from their inquiry, that the disease which had 
excited the alarm in the village had broken out nearly a month 
before ; but no mention is made by Mr. Tully of any sickness 
in the Casa Politi ; nor do I know whether he was at all aware 
of it, though I rather think not. 

In Mr. Tully's official report of the prevailing sickness at Mara- 
thea, he seems to detail in a distinct manner the general train of 
plague symptoms ; and I am at some loss to account for the 
conclusion he came to, that the disease was not plague ; whilst 
at the same time certain measures of restraint were recom- 
mended, and to a certain degree carried into effect. 

About the time the report from the justice of peace was 
transmitted to the city, there was a considerable degree of 
alarm prevailing in Marathea on account of the sickness, which 
naturally extended to the seat of government. Soon after, it 
was thought proper to take measures of precaution to preserve 



160 NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 

the city. Troops were therefore sent down to Lefchimo ; a cordon 
was established, so as effectually to cut off that district from 
the rest of the island ; barriers were fixed, and other means 
adopted to prevent all means of communication between the 
city and the rest of the country. 

The people of Marathea were unable to account for this 
violent disease, which had appeared so suddenly, and was so 
fatal, among them, and superstition imputed it to some evil 
spirit that had got amongst them. They were taken ill in the 
most unaccountable manner ; and when asked what was the 
matter, they said they could not tell, but at times they felt as if 
they were mad. Furious delirium and violent exacerbations 
of fever were particularly remarked. With the view of driving 
away this imaginary demon and tormentor, a convocation of 
certain clergymen was called, public prayers were made, and 
other religious ceremonies were performed. The following- 
clergymen formed this council, or convocation — -viz., the Papas 
Coluri and Meari, belonging to Perivoli ; and the Papa Metaxa, 
belonging to Anaplades, in the lower part of the district ; and 
in the execution of their solemn and religious duties, according 
to the rites of the Greek church, they entered the sick houses 
and had free intercourse with the diseased, after which they 
returned to their own homes, carrying the contagion along with 
them, as was lamentably discovered soon after. 

The family of the Papa Coluri at this time, as reported to me, 
consisted of seven persons. He himself died on the 16th of 
December, three more died about the 24th, one on the 31st, 
one on the 1st of January, 1816, and only one escaped. 

The family of the Papa Meari, belonging to the same village, 
consisted of four persons, of whom two died suddenly about that 
time. 

The malady thus introduced into Perivoli was still further 
disseminated by the imprudence of Coluri' s wife ; as reported to 
me by Mr. Muir, assistant-surgeon of the medical staff, who was 
for a long time resident in that village, for the purpose of look- 



ITS INTRODUCTION AND PROGRESS. 



161 



ing after the health of the inhabitants. That officer gave me the 
following relation : — When the Papa Coluri died, from motives 
of charity, and perhaps in compliance with the wishes of her 
departed husband, his wife distributed his personal clothes 
among the poor of the parish, giving to some his shirts, to others 
various articles of his wearing apparel ; and it was remarked that 
all who had received of these presents, died, as also almost all 
their families, the disease seeming to spread among them like 
wildfire. The wife herself fell sick, and died a few days after 
her husband. 

I have already noticed how fatal the malady was in the family 
of the Papa Metaxa in Anaplades ; but I could not learn the 
particulars of the extension of the disease thus introduced into 
that town; at least, I could not trace it with that degree of accu- 
racy which would authorize my detailing it here ; but it did 
extend itself after the Papa's return thither ; and I ascertained, 
as I have already mentioned, that there had been no plague 
there before. 

Whilst these things were going on in the villages of Perivoli 
and Anaplades, the malady was further extending itself in the 
unfortunate village of Marathea, which, at the breaking out of 
the disorder, consisted of 48 souls. Of all these, only 14 re- 
mained at the time I left the district, of which number three 
recovered from the disease, and eleven escaped it altogether, 
by having been removed to an encampment, after the village 
was burned, on or about the 29th December. 

Some time after the three papas had held their famous coun- 
cil at Marathea, it appears that two more of these clergymen 
belonging to Argirades, a neighbouring town, went thither also, 
with a similar intention, and to assist at the burials of the 
dead. 

These were the Papas Janni Pannojotti and Theodoro 
Catavatti. The family of the former consisted of live persons, 
of whom he himself and three died in a short time, only one 
escaping. 



162 



NARRATIVE OF THE PLAGUE OF LEFCHIMO. 



The other papa, Catavatti, I understood was a solitary indi- 
vidual of retired habits, living all alone. He also fell sick, and 
died soon after his return from Marathea. 

I was likewise informed, that about the time the two last- 
mentioned papas went to Marathea, for the purpose of perform- 
ing their religious ceremonies, a poor labouring man, named 
Luli Pandi, a native of Argirades, went thither also to see 
Masaracci's family, and buy some corn, and stayed there a day 
or two, for the purpose of assisting the family in various offices, 
This was the first person who died of the plague in Argirades. 

For this information respecting Argirades, I am chiefly in- 
debted to Assistant-Surgeon Alexander, who had been stationed 
there for several months to watch over the public health in that 
place, and who thereby had the best means of gaining infor- 
mation on the subject. This testimony was besides confirmed 
from other sources. 

The same medical officer favoured me with a statement of 
those attacked by the disease up to the 1st of February, 1816. 
He makes the whole number to be thirty-nine, of whom thirty- 
two died, and seven recovered. Of the former, four belonged 
to the family of the unfortunate labourer Pandi, who was acces- 
sory to the introduction of the malady, which seems to have 
attacked the relatives of this man with singular violence, for I 
observe in the nominal list of deaths not fewer than twelve per- 
sons named Pandi, several of whom were connected with him. 
Thus by these unfortunate individuals was the disease caught, 
and communicated to the relatives and the families with whom 
they had intercourse. 

From February the 1 st to the 1 7th, no case of plague occurred 
in the village. The work of expurgating the houses was 
going on, and the disorder was supposed to have been sup- 
pressed there. But about that time it re-appeared, in consequence 
of imprudent intercourse which had taken place betwixt one 
of the expurgators and the people of the town, as already 
mentioned. Mr. Alexander states that by this second invasion 



ITS INTRODUCTION AND PROGRESS. 



163 



of the disease, fifty -four persons were attacked, of whom thirty- 
nine died and fifteen recovered. 

Troops had been sent into the impested district about the 
28th of December, with general instructions to prevent inter- 
course among the villages. But I am not aware that at that 
time it was considered prudent or safe to quarter them in 
the villages. Shortly afterwards the people were directed to 
confine themselves strictly to their houses, and parties of mili- 
tary were sent in to see that these orders were complied with. 
Patroles also of the inhabitants themselves were ordered to 
prevent all intercourse, but I am disposed to think that these 
civic guards were very remiss in the performance of this im- 
portant duty ; and I have the more reason to believe that this 
was the case, as many of them could not be persuaded that the 
disease was plague, and were quite impatient at anything like 
quarantine restraints ; consequently they were of little or no use. 

These measures, so far as they went, were, no doubt, very 
proper. But from all the information I received, I am inclined 
to think that they were not acted upon with sufficient vigour, nor 
carried into full extent, so that it became necessary afterwards 
to trust as little as possible to these domestic guards, and to 
rely only on the military, who were subsequently quartered in 
the villages, and directions were given to enforce, by the severest 
examples, should such be found necessary, a proper obedience 
to the quarantine restraints, in preventing all external, as well 
as all internal intercourse, except what was authorized by the 
rules of the quarantine. Medical officers were then sent to these 
villages to attend the health of the inhabitants, and examine 
them frequently, so as to lay hold of the disease the moment it 
showed itself. 

Not only were the troops, although constantly employed in 
traversing the villages, day and night, exposed to no additional 
danger, whilst they acted in strict conformity with their orders, 
which were to avoid all communication with the inhabitants, but 
in the space of ten days from the time their orders were effectually 



164 NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 

put in force, the second invasion of the plague in Argirades was 
completely extinguished, and never appeared afterwards. 

But whilst I mention it as a fact not to be disputed that troops 
and other persons may be employed in the police duties of 
plague and yet escape the malady, if they avoid all contact with 
impested persons or goods, still it is not for a moment to be 
doubted but that they are as liable as any to be attacked by it, 
should they be so abandoned and lost to all sense of honour and 
propriety as to violate their orders, which they are sometimes 
tempted to do, in the hope that they may escape with impunity, 
or that their crime may remain undiscovered ; or that, after the 
lapse of a certain time, and the intervention of other circum- 
stances, which they themselves calculate upon, there is no 
danger to be apprehended ; as the following instance proves. 

Some time after the detachment of De Rolle's regiment was 
stationed at Argirades, and when, from the favourable state of 
the public health in the village, the dread of the plague had in 
some degree subsided, one of the soldiers, thinking that the 
plague was now all over, and that there was no further danger 
of contracting the disease, secretly left his post, and went into 
one of the impested houses in search of wine and plunder at the 
time it was expurgating, and having had communication with 
the expurgators, joined his guard, without their being at all 
aware of the circumstance, or suspecting where he had been. 
Soon after his return, he was taken ill, and died in about twenty- 
four hours from the commencement of the attack. His illness, 
which was immediately ascertained to be plague, naturally 
caused great alarm ; and those in the same tent were now 
instantly separated from the rest of the detachment, and placed 
in rigid quarantine. Unfortunately, however, the man himself 
was not the only sufferer ; for notwithstanding that prompt 
measures were used, the disease attacked seven men of the 
detachment before it was got under, of whom five died, and two 
recovered, mostly, if not all, of his own comrades, who lodged 
in the same tent with him. Had not these measures of separa- 



ITS INTRODUCTION AND PROGRESS. 



165 



tion been carried into effect the moment the disease was dis- 
covered, I have not the least doubt but that the greatest part, if 
not the whole of the detachment, which I think at the time con- 
sisted of an officer and eighteen men, would have suffered. 
The blankets, and, in short, every susceptible article which they 
possessed, except the clothes they had on at the time, were 
immediately burned. 

About this time an instance of escape somewhat singular 
occurred to an officer of De Rolle's regiment, while he was sta- 
tioned in the village of Argirades. He had occasion to send 
one of his men on a message, who was to bring back a paper 
parcel. The man when ordered on this duty appeared in 
perfect health ; for if there had been anything known to the 
contrary he would not have been put on any kind of duty. 
Shortly after he returned, and delivered the parcel into his 
officer's hands. At this time he appeared to be drunk, and was 
severely reprimanded for his conduct. Soon after he became 
very ill, and on examination was found to have the plague. 
He was sent to the hospital, where he died. The officer him- 
self escaped, but his feelings for the next fifteen days were 
not very enviable ; for although every human precaution was 
adopted, it could not be said that he was free from plague till 
the expiration of that period. 

Signor Trivoli, a gentleman of considerable property in 
Rumanades, and an intelligent man, who resided in his own 
house in the village, during the whole time that the plague was 
raging in the district, and who was intimately acquainted with 
the people not only of his own village, but also of the neigh- 
bourhood, gave me the following account of the introduction 
and progress of the malady there. 

The disease was introduced into this village from Marathea 
in the following manner: — A son of Marco Masaracci, whose 
family was the first attacked in Marathea, was married to 
a native of Rumanades, the daughter of a woman named 
Nicolitta Critica, and resided in this last place. This man, 



166 NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 

named Demetrio Masaracci, hearing that his family were sick 
at Marathea, went oyer to see them. Shortly after his return, 
his family, which consisted of five persons, fell sick, and three 
of them died suddenly. The first victim was Nicolitta Critica, 
his mother-in-law, about forty years of age. 

Two or three days after this, the Papa Janni Duca, the 
clergyman of the village, who, it seems, had also been at 
Marathea to offer his prayers on the melancholy occasion, fell 
sick on his return to Rumanades, and impested his family, 
which consisted of four persons. He himself and his son died 
in four or five days. His wife died a short time afterwards in 
the encampment which had been formed near Marathea, to 
which she had been removed after that village and Rumanades 
had been burned, so that only one of the family escaped. 

Signor Trivoli further stated that about this time an inhabi- 
tant belonging to the village, by name Marino Duca, had a son, 
who was married to a woman of Marathea. A female relation 
of this woman was sick there, and he and his wife went over to 
see her. They found her very ill, and she died in a day or 
two afterwards. 

Duca and his wife being the nearest heirs to this woman's 
property, carried her effects to their own house in Rumanades. 
The family shortly after fell sick, and of six individuals com- 
posing it, five died in a short space of time. The only one who 
survived was Duca's wife. 

The total number of persons in the village, before the 
breaking out of the malady there, was forty-nine, of whom six- 
teen died ; and these mostly belonged to the families who had 
been at Marathea. 

I think it is thus clearly ascertained that this malady is pro- 
pagated not only by impested persons, but also by impested 
goods. 

Neochori was attacked in the following manner : — The wife 
of one of the villagers, named Panajotti Zervo, went to the 
village of Argirades, about a mile distant, to see her brother, 



ITS INTRODUCTION AND PROGRESS. 



167 



Spiro Cusciatte, and his family, who were ill at the time the 
sickness prevailed there. This was about the eighth of March, 
and when that village was impested a second time, as already 
stated. During the first time the plague raged in Argirades, 
the village of Neochori continued healthy, the inhabitants being- 
obedient to the quarantine orders ; and happy would it have 
been for them had they always continued so. 

It appears that this woman was in a state of pregnancy at the 
time ; that on the twelfth, four days after her return, she was 
taken very ill, and died, of what was supposed to be the con- 
sequences of abortion, and not of the plague, for the body ex- 
hibited no peculiar symptoms on examination after death. Her 
husband was the next person attacked, and had buboes in both 
groins. In his delirium he escaped from his house, and died 
on the fourth day from the attack.* 

Another of the inhabitants was suddenly seized with giddiness 
and staggering whilst at work in the fields, which he attributed 
to having hurt his foot. He went home, and died the next 
day. 

A boy, named Janni Mexia, ten years old, was attacked with 
a high degree of fever, and a swelling in his neck, on the twelfth 
of March ; and died the next day in the pest-hospital es- 
tablished at Santa Trinita, a short distance from the village. 

The mother of this boy, most deeply affected when her son 
was ordered to the hospital, pretended that she also had the 
plague ; and complained of pain and swelling in the groin. 
And I have no doubt, from her distracted state of mind, but she 
was very unwell. Her object, however, was to obtain leave to 
accompany her child to the hospital, in order to attend on him 
herself, and watch over him with all a mother's care ; thinking, 
what was no doubt very true, that her own attention to him 
would be greater than could otherwise be expected in a plague 
hospital ; but without reflecting for a moment on the additional 

* The removal of the sick was not at this time so prompt as afterwards, nor 
the system carried into such immediate and vigorous effect. 

N 2 



168 NARRATIVE OF THE PLAGUE OF LEFCH1M0 ; 

danger she herself was exposed to by entering that hot-bed of 
disease. She did accompany him thither, and the next day 
had to experience the agony of seeing him carried out dead 
from it. 

This unhappy woman remained in the hospital several days, 
evidently ill, but without decided symptoms of plague. She 
was doomed, however, to encounter another trying scene. Her 
husband, Spiro Mexia, was attacked by the disease, and sent 
from the encampment, to which his family had been removed, 
to the hospital on the 18th, and died on the 22nd. She herself 
at last showed decided symptoms of plague on that day, and 
was admitted as a patient. She died the following day. Both 
had petechias, and she herself had, in addition, a carbuncle on 
the breast. 

As the village had been hitherto healthy, no troops had been 
sent into it ; and, in short, the inhabitants were under no kind 
of restraint, except that of being directed not to go to the iin- 
pested towns, or have any intercourse beyond their own im- 
mediate community. When, however, the disease was intro- 
duced in the way I have mentioned, and as the extent of the 
mischief could not be ascertained from the promiscuous inter- 
course which had taken place amongst them, it was determined 
to remove the whole of them, except the Primate's family, to an 
encampment, which had been already formed at a short distance, 
in order the more effectually to watch over their health, and to 
lay hold of the disease the moment it appeared. This was the 
more easily done, as the number of the inhabitants was small ; 
and, by so doing, the duty among the troops, which at that time 
was severe, was not increased. 

According to the statement which I received of the disease in 
this village, the deaths were fourteen and the recoveries three. 

The disease was introduced into Cuspades in the following 
manner : — 

The clergyman of the parish, the Papa Stephano Allessi, had 
a brother residing in Rumanades, who, during the time of 



ITS INTRODUCTION AND PROGRESS. 



169 



the sickness there, became alarmed for his own safety ; and 
in order to escape the contagion, came to stay with the Papa, 
never thinking of the possibility of his being already impested 
from any previous intercourse with the people of his own village. 
Soon after his arrival in Cuspades he felt himself ill, and died 
suddenly. The Papa's family became also impested, and all of 
them died. From them the disease spread to other families in 
the village. The number attacked was fifteen, of whom twelve 
died and three recovered.* 

On a particular examination of the inhabitants of this village 
some months afterwards, it was discovered that several of them 
exhibited marks as of buboes ; and these appearances, coupled 
with their own accounts, that they had felt slight indisposition 
at the time they had these swellings, led me to suppose that 
they had had the plague in a mild degree ; and that, for fear of 
being removed from their houses, they had carefully concealed 
the circumstance. These appearances were observed among 
the inhabitants of some of the other villages also. 

One of these families I thought it incumbent upon me to send, 
with their susceptible effects, to the camp, to perform quarantine, 
as I was not at all satisfied that they had purified their pro- 
perty. I also directed their house to be expurgated on their 
removal from it. When, afterwards, their health and effects 
were proved by time to be free from plague, they were sent back 
to their village ; for I thought it necessary to leave nothing to 
chance on an occasion like this. 

Monsieur Saisset, the medical gentleman resident at Clomo, 
favoured me with an account of the introduction of the disease 
into that village, where he was stationed from the end of 
December, 1815, till the final removal of all quarantine 
restraints. 

From his account, as well as from other sources, I learned 

* This shows how careful one should be in the time of plague not to admit 
strangers into a healthy place, particularly those coming from where the 
plague is known to exist. 



170 NARRATIVE OF THE PLAGUE OF LEFCHIMO j 

that the malady was brought into the village from Marathea. 
A man of the name of Tassi Lavrano, was married to a woman 
belonging to Marathea ; this woman went there to see some of 
her friends, who were ill at the time the sickness prevailed there 
in December. The day after her return to Clomo, she and her 
family were attacked by the disease. 

Of the six individuals composing this family every one was 
attacked, and five died. The sixth, Constantino Lavrano, a lad 
fifteen years old, recovered, after a very severe illness. From 
them the disease spread to the other families in the village. 
M. Saisset, on his arrival, found the sick scattered all over the 
place. 

His first step was to collect the sick into one place in the 
best way he was able, and to recommend to those families who 
were healthy, to avoid all intercourse with the rest ; and these 
necessary orders he endeavoured to enforce by every means in 
his power, until the arrival of the troops, when quarantine 
measures were adopted. 

He states in his report that he received into his hospital 39 
patients, of whom 28 died, and 11 recovered.* From the best in- 
formation he was able to obtain, he makes the deaths before 
his arrival amount to 18, making in all 46. The dead bodies, 
previous to his arrival, were buried in houses, and in different 
places in the neighbourhood, which caused much trouble and 
vexation afterwards. 

The same distressing occurrence happened among the 
military stationed here, as took place in Argirades, and from the 
same cause. 

The detachment of De Rolle's regiment, stationed within the 
village for this and various other duties, consisted of an officer 
and 39 non-commissioned officers and privates. One of the 
men, most shamefully, and in contravention of the orders so often 
given, the necessity for which was also most strongly impressed 

* M. Saisset transmitted to me some of the most interesting of these cases, 
which will appear in the Appendix. 



ITS INTRODUCTION AND PROGRESS. 



171 



upon their minds, entered the house of an impested family, 
supposed to be rich, in the hopes of finding there some valuable 
plunder, and after ransacking the house, contrived to return to 
his comrades without letting them know where he had been. 
He fell sick soon after, and then confessed what he had done. 
This, of course, alarmed the whole detachment exceed- 
ingly ; for as they were all in free intercourse with one another, 
no one could consider himself safe, or say how long he might 
escape the disease. As the case was unequivocally plague, the 
man himself was immediately sent to the hospital, where he died 
the fourth day after. 

The men having all mixed together, it was impossible to 
foretell where the mischief would end; and no human pre- 
cautions could counteract what was already done. Whenever 
any of them fell sick, they were instantly separated and sent to 
the hospital. Every article of a susceptible nature which they 
possessed, was forthwith destroyed, after which they were re- 
moved to the camp, which at this time was concentrated near 
the Casa Politi, to perform a strict quarantine, where those in 
one tent were prevented from mixing with those of another. 
By these means the malady was put a stop to in the space of 
ten days, betwixt the 15th and 25th of March, when the last 
case of plague occurred among them ; but this was not before 
ten of them were attacked, seven of whom died, and three re- 
covered. In this case I have not the smallest doubt that unless 
these prompt and decided measures had been adopted, the con- 
tagion would have spread to the whole, or, at least, would 
have been considerably more fatal. 

I find by the returns sent to me, that during the ten days the 
plague was existing in this detachment, three of them had been 
sent to the hospital previous to its removal, and seven after- 
wards. The remainder of the detachment, with their officer, 
were afterwards removed to the camp district, to finish their 
quarantine, and were made available for the duties there. 

Saint Demetri is a small village, about a mile distant from 



172 NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 

Clomo, and was supposed to be impested from it ; but I was 
never able to trace the chain of communication. One family 
only was attacked there, of which two persons died ; but the 
family being immediately removed with their effects, and their 
house expurgated, the malady was speedily suppressed. 

I could never learn to my own satisfaction the precise 
manner in which the village of Critica became impested ; but 
from all the information I was able to collect, the disease here, 
as well as in the village of Demetri, was confined to one family, 
named Vlassi, which showed symptoms of plague on the 10th 
of March. The family were removed from their home, the 
moment symptoms appeared in it. It consisted of five peisons, 
of whom four died, and only one, a young woman with two car- 
buncles, recovered. The deaths were as follow : — one on the 
12th, one on the 14th, one on the 15th, and the last on the 16th. 
By these prompt measures the disease was speedily rooted out, 
and never appeared there afterwards. 

In this village, as well as in Saint Demetri, I can only at- 
tribute the exemption of the people from the disease for so long 
a time, to their having cautiously avoided intercourse with the 
neighbouring villages when the plague was raging in them ; for 
they had a great dread lest the calamity should find its way into 
their village, and kept themselves apart from their neighbours ; 
and to this cause alone I impute the non-extension of the 
malady when it was introduced ; for by this time, the system of 
avoiding all intercourse was so well understood by the in- 
habitants, that no family would intermix with another. 

It is highly necessary in time of plague to keep alive this 
dread of contracting the disease, which is one of the most 
powerful means we possess of preventing any intercourse from 
taking place, and thus to keep the malady in check. And, in- 
deed, without this, all our efforts will often be rendered nugatory. 
Wicked persons may, from various motives, be guilty of violating 
the laws of quarantine, which circumstance cannot, perhaps, be 
immediately known, (and they themselves will probably be the 



ITS INTRODUCTION AND PROGRESS. 



173 



sufferers for such misconduct,) but if all intercourse with them 
is avoided, the malady cannot do much mischief. 

In the instance of this family it appears that the symptoms 
of positive plague manifested themselves at once, and the im- 
mediate removal of the whole became a matter of imperious 
necessity for the safety of the rest of the inhabitants, who 
thereby happily escaped. 

The remaining villages of upper Lefchimo, Coracades, Vasil- 
latica, Colochiti, &c, I have reason to believe were never 
impested ; for during my residence in the district I was at great 
pains to ascertain this fact, not only personally, on my different 
tours of inspection in these villages, but also from every other 
source whence I was likely to gain correct information. The 
villages were small, and, as I have been informed, little inter- 
course at any time took place between them and the others. 
After the arrival of the troops in the district, the impested 
villages were cut off from those that continued healthy, or, as it 
was termed, clean. They were allowed to have free intercourse 
tvithin themselves, but not permitted to have any communication 
with those actually impested, nor even with any other of the 
clean or healthy villages ; and if any one was found trespassing 
these orders he was punished in some way or other for his mis- 
conduct. 

Latterly, however, when they saw the ravages of the disease 
all around them, and found that by acting up to these orders 
they escaped, there was less danger of their attempting to violate 
them. 

It may be thought by some that the villages which were clean 
ought not to have been interfered with, or subjected to any re- 
strictive intercourse among one another, and that it was time 
enough to do so when sickness appeared in them. But to this 
I answer, that it would have been then too late, for we ought to 
anticipate the enemy ; and so far were the measures here pro- 
posed from being harsh and cruel, that they were considerate 
and merciful in the highest degree, not only towards the people 



174 NARRATIVE OF THE PLAGUE OF LEFCHIMO j 

themselves, but also towards the community at large. For who 
could tell that, if left entirely to themselves, they might not at 
some time or other have clandestinely visited the villages where 
the plague was raging or still lurking, and have brought back 
the disease with them, which might eventually have prolonged 
the quarantine of the impested villages, and, indeed, of all con- 
cerned. It was to prevent the possibility of this being done 
that the people were thus confined to then* own villages. This 
they no doubt thought at the time a very great hardship ; and 
many representations were made to me upon the subject. But 
I would not yield to their remonstrances. The principal object 
in the first instance was, by every human means to eradicate 
the plague ; when, as a matter of course, the removal of all re- 
straints whatever would follow. 

In the time of plague, suspicion and a want of confidence 
are unavoidable, and we cannot, on many occasions at least, 
believe what is said, or the promises that are made. Persons 
of the highest integrity, under such circumstances, cannot be 
fully depended upon. The laws of health do not acknowledge 
or countenance the term honour in its common acceptation, and 
we must trust as little as possible to any one. 



CHAPTER III. 

Propagation of the plague in Lower Lefchimo — Saint Theodoro impested — 
Also Melechia — People anxious to conceal indisposition in the time of 
plague — A pest hospital ought not to be established in a town if it can 
possibly be avoided — Cruelty and inexpediency of burning impested houses 
— Removal of the susceptible effects from impested houses — Effects of per- 
sons simply suspected — Permission granted in Lefchimo to the class of 
simply suspected to take their effects along with them to the camps — 
Punishments sometimes necessary. 

Having traced the malady from its development at the Casa 
Politi and the village of Marathea to the other villages of the 



ITS INTRODUCTION AND PROGRESS. 



175 



upper district, I shall now briefly prosecute the same subject in 
the lower district, in the five neighbouring villages of Ringlades, 
Anaplades, Saint Theodoro, Potami, and Melechia, where it 
was lurking at the time I was nominated to the superintendence 
of the plague duties ; and where it afterwards frequently ap- 
peared, but was always immediately checked, and finally era- 
dicated in a short space of time. 

The other four villages in the lower district, Neocori, Paleocori, 
Dragotina, and Spartuo, were never attacked by the malady. 

The five villages I have mentioned as attacked by the plague, 
are all situated close to each other, as is seen by the map, and 
the whole distance from Ringlades to Melechia is little more 
than an English mile. Indeed, Potami and Melechia may be 
considered but as one and the same, being only separated by 
the small river Potami. 

I have already stated that Anaplades became impested direct 
from Marathea, by the papa Metaxa ; and the disease soon 
after spread over that village. 

I am without a particular account of the families who were 
first attacked here ; but I know that it spread after communi- 
cation with the papa's family. 

Mr. Sammut, assistant-surgeon of the Corsican Rangers, a 
very diligent and zealous officer, was appointed to the care of 
the pest patients in the hospital which was established at Saint 
Theodoro, and continued in that charge till it was broken up, 
and transferred to the camp district near the Casa Politi. 

I am not quite sure that it was precisely known in what manner 
Saint Theodoro became impested ; but it was distinctly ascer- 
tained that the malady appeared there subsequent to its 
appearance in Anaplades. It might therefore have become 
impested from that place, from the usually existing intercourse, 
or it might have been introduced in the manner detailed by 
Mr. Sammut, who resided for several months in that town, in 
charge of the hospital established there, and was at great pains 
to investigate this matter. 



176 NARRATIVE OF THE PLAGUE OF LEFCHLMO; 

He states that the malady broke out there early in January, 
and that it was imported direct from Perivoli in the following- 
manner : — 

The nephew of the Papa Colluri (who, we have seen, resided 
in Perivoli, and was amongst the earliest victims of the plague 
in that village) was married to a woman named Panajotti, belong- 
ing to Saint Theodoro, who with her family lived there. At the 
time the sickness prevailed in the Papa Colluri's family, this man 
went to see them, and soon after his return one of his children 
fell sick of what was supposed to be a sore throat, with swelling 
of the neck. A woman named Vlacca, who was considered to have 
some skill in such complaints, was sent for to see the child, 
and give her advice. Soon after, another of the family fell ill. 

The woman's method of treating complaints of this kind, 
seems to have been a very rough one. She put her finger into 
the child's mouth, and irritated the internal fauces and inflamed 
glands. The poor child died in about two hours after this 
operation, in very great agony. Soon after, the rest of the 
family fell sick, one after another, and died suddenly. Last of 
all, the father, who had been at Perivoli, and brought back the 
disease with him, was also attacked, and died. 

In the meantime, the woman Vlacca, who had gone to cure 
the boy, began to complain of being unwell. By and by the 
whole of her family fell sick ; and of eight persons conrposing 
it, seven died suddenly and unaccountably, and the eighth, 
Andreanella Vlacca, who had a bubo upon her groin, very 
narrowly escaped with her life. 

A family named Bulgari lived close to that of Panajotti, and 
both were in the habit of visiting each other. At the time, 
therefore, of the sickness in Panajotti's family, the Bulgaris went 
to see them. They became thus immediately impested, and 
the disease spread so rapidly over that unfortunate family, that 
five of them died after two or three days' illness ; and the whole 
family, which consisted of nine persons, became in a short time 
extinct. 



ITS INTRODUCTION AND PROGRESS, 



177 



The disease thus introduced into Anaplades and Saint 
Theodoro soon spread to the other villages by propagation. 
It started here and there, and sudden deaths, which at the time 
could not be accounted for, were frequent. The disease would 
seem to languish for awhile, and then reappear with sad havoc 
in some families, whilst others entirely escaped. 

The village of Melechia, although only separated from Potami 
by a small river, kept itself free from the calamity for a long- 
time, by avoiding all communication with it and the other vil- 
lages, at the time the malady was raging in them. But at length, 
trusting too much to their security, and probably, also, from some 
of the inhabitants, from avaricious motives, having had clan- 
destine intercourse with the impested villagers, which was sus- 
pected, but not proved to my satisfaction, the malady was intro- 
duced, but was speedily suppressed by the plan of management, 
which by this time was more fully understood and acted upon 
than it had been at the first breaking out of the disorder. It 
reappeared after a considerable length of time, and this reap- 
pearance was satisfactorily ascertained by Mr. Tully to have 
been owing to clandestine intercourse. Yet the chief magistrate 
of this very village, the primate Canta, whose wife and child 
died in the hospital, persisted to the last in maintaining that 
the disease was not plague, as I have before mentioned. 

A want of documents prevents me from tracing the disease 
through all these villages, and from following its various evo- 
lutions in them. But, from what I have already said, I trust 
that the further prosecution of the subject as to the contagious 
nature of plague, and of its being propagated by contact, will 
appear to be quite unnecessary. We have shown that it fre- 
quently started among these villages, and that its appearance 
was almost always ascertained at the time to have followed 
some violation of quarantine. 

In the time of plague, it is scarcely possible to get a correct 
account of the deaths it causes, particularly at the beginning. 
The fear of being pronounced impested induces families 



178 



NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 



carefully to conceal them ; and this was proved to be the case in 
Lefchimo. Indeed, there is no means of ascertaining the matter 
but by careful medical inspection. 

It was this dread of being considered impested, which in the 
beginning made the inhabitants most carefully conceal every 
kind of indisposition which occurred among them, and keep all 
so secret, that until we had ascertained the number of persons 
in each family, and had recourse to daily inspections by medical 
gentlemen, (and I must be allowed to say that those belonging 
to the British medical staff were by far the most diligent and 
efficient in the execution of this most important duty,) we never 
could perfectly know who were sick or who were well. Then, 
and not till then, were we able to ascertain what was going on, 
and to act with promptitude in laying hold of positive disease, 
removing the suspected, &c. 

Mr. Sammut favoured me with a return of plague admissions 
into the hospital at Saint Theodoro, from the 28th of January 
to the 28th of the March following, when it was broken up, and 
transferred to the camp district, as will be noticed hereafter. 

The total number admitted amounts to 147, of whom I find 
that 88 belonged to the village or town of Saint Theodoro. Of 
these only seven recovered, and of the whole only fifteen, 
making nearly one in ten. 

Without being perfectly aware of all the circumstances, I am 
disposed to attribute the great number of admissions from Saint 
Theodoro itself, (although it is certainly larger than any of the 
other villages,) to the establishment of the hospital in it; 
which, indeed, was unavoidable, as there was no place in the 
neighbourhood which could be occupied as such. I beg here 
to observe that I am averse to an hospital being in a town, if it 
can possibly be avoided ; for although every possible arrange- 
ment be made so as to cut off all communication with it, yet it 
is more likely that clandestine intercourse may take place with 
this hot-bed of plague, than if it were at a distance from the 
community. We ought therefore, in this, as in everything 



ITS INTRODUCTION AND PROGRESS. 



179 



else connected with plague, to trust as little as possible to 
chance. 

Having in the Introductory Discourse pointed out the ineffi- 
ciency and cruelty of burning impested houses, as a means of 
arresting the plague — a plan of operation, which, I again re- 
peat, ought never to be resorted to, — let us turn for a moment 
to the removal of the susceptible furniture and effects from a 
house attacked by plague. 

This, indeed, is no easy task ; and one which I conceive 
ought only to be performed by the expurgators, in consequence 
of the danger attending it. The people themselves will doubt- 
less be anxious to save their property, and to prevent its falling 
into the hands of a set of men who it cannot be expected will 
be careful of it, and who, in spite of every advice and injunc- 
tion that can be given them, will sometimes destroy it even 
wantonly. This, when it happens, is extremely to be regretted ; 
because no one, except those employed, can touch or interfere 
with the articles, without running the dreadful risk of becoming 
also impested. And, indeed, although the owners themselves 
may, from earnestly wishing to preserve their property, offer to 
take charge of it themselves, and purify it whilst performing 
their quarantine, yet I think it is questionable how far this 
permission can be granted in every instance, from the additional 
risk to which they are exposed, notwithstanding their already 
being in a state of high suspicion. 

Latterly, however, permission was granted to this class to 
take as much of their goods with them as they could ; which 
they purified whilst performing their quarantine. But it is one 
thing to expurgate the description of small and miserably fur- 
nished houses in Lefchimo — and another thing, the large, well- 
furnished houses, for example, in England. In the one case, all 
the susceptible articles they had could be removed; in the 
other, the thing is impossible. No means of transport could be 
provided, and even could that be done, it is hardly to be ex- 
pected they could have proper convenience. The most that 



180 NARRATIVE OF THE PLAGUE OF LEFCHIMO ; 

could be done is to take their most valuable effects with 
them. 

With regard to the effects of those who are simply suspected, 
the case is different. The public safety, no doubt, requires that 
the persons themselves should be separated from the commu- 
nity ; but their effects being in the same state with themselves, — 
viz., simply suspected; see Introductory Discourse, p. 38, — they 
ought to be permitted to take with them every article they 
choose. It would be a most unjustifiable act to deliver up their 
houses to the expurgators, at least before positive disease 
appears among them. 

Whenever the disease broke out, and it became necessary to 
send persons of this class to observation, I invariably afforded 
them every facility in my power to take with them whatever 
they chose. The permission thus granted had many advan- 
tages; for some of the things they earned with them added 
not a little to their comfort. Their effects also were thus in 
safety under their own care ; whereas, had they been left in 
their houses, they might have been robbed or plundered ; and, 
lastly, the period of their restriction was thus ultimately dimi- 
nished by their performing their quarantine of observation, and 
purifying their goods at the same time ; so that when they re- 
turned to their homes afterwards, they had nothing to fear from 
suspicion of plague remaining in them ; and I am firmly per- 
suaded that if this plan had been adopted earlier, much of the 
people's goods would have been saved, and they themselves 
would have been less reluctant to leave their houses, for obser- 
vation, seeing, as they would then have done, that we had no 
wish to destroy or injure their property. Some took with them 
every article of a susceptible nature which they possessed ; 
others, only what they judged most valuable. In giving 
this permission I could not, of course, violate the laws of qua- 
rantine, and endanger the health of others, by allowing those 
free of suspicion to assist them in their transportation ; but they 
were suffered, under a military escort, to carry with them all 



ITS INTRODUCTION AND PROGRESS. 



181 



they were able to take. The military duty was thus unavoidably 
increased, but this could not be helped. It was of the very 
first importance to quiet the minds of the people, and show 
them clearly that we were anxious not only to subdue the 
plague, but, at the same time, to make the calamity bear as 
lightly on them as possible. It is doubtless proper to act with 
firmness, decision, and impartiality on such occasions ; but 
much of the horrors of plague may be softened down by mild 
conduct and conciliatory measures. For, as I have already 
observed, people suffering under one of the greatest scourges 
that can afflict humanity, overwhelmed with sorrow at the loss 
of their dearest relatives and friends, and labouring under dread- 
ful uncertainty as to their own fate, loudly call for everything 
that can soothe their distracted feelings. Yet, with every wish 
and endeavour to do so, it will sometimes happen that our 
very best efforts to accomplish this object will be construed into 
harshness and cruelty. We are not, however, on this account, 
or any other, to deviate from what is right and proper. 
The punishment of those who are guilty of a violation of the 
laws of quarantine is not the least painful duty we have to per- 
form in the time of plague. Yet, without making some severe 
examples at times, particularly at the commencement, it will 
often not be found practicable to conduct the police manage- 
ment. 

I have already noticed that during the period of my super- 
intendence, it was not found necessary to have recourse to severe 
measures, except in one instance, the particulars of which are 
as follow : — 

One of the condannati, or felons, employed as an hospital 
servant, having got drunk, became extremely outrageous, and 
maltreated Dr. De Georgio, the gentleman in charge of the 
hospital. The circumstance was soon after reported to me, 
when I immediately ordered him to be confined, and sent off 
a dispatch to head-quarters to apprise Major-General Phillips 
of the matter. I received an answer to say that a court-martial 

o 



182 NARRATIVE OF THE PIAGUE OF LEFCHIMO j 

should be appointed to try the man ; and that if found guilty, 
the full sentence of the law should be inflicted on him, as an 
example to others. 

Lest he should escape, and consequently do mischief, he was 
ordered to be secured by the other servants in the best manner 
circumstances would permit, and placed under the charge of a 
sentinel, to whom orders were given to prevent his escape (as 
he himself would be made answerable for his escape with his 
own life,) until a court-martial had decided the fate of his pri- 
soner. The fellow made frequent endeavours to extricate him- 
self ; upon which he was repeatedly desired by the sentinel to 
desist, adding that he would otherwise execute the orders he had 
received. In the night, however, he had nearly effected his 
purpose, when the soldier, in execution of his orders, shot him 
dead, before the necessary arrangements for a court-martial 
were completed, which, no doubt, would have awarded the 
same punishment to the delinquent. 

It is necessary at all times to keep up a proper degree of 
subordination, but it is particularly so in a plague hospital, 
where, from the very nature of the establishment, we have 
to do with such bad characters. I learned, too, that this fel- 
low said he was determined to escape, and make his way to 
Perivoli, a neighbouring village, which with very great diffi- 
culty we had lately cleared of plague. And had he succeeded 
in his attempt, I have no doubt but he would have re-im- 
pested it, and we should thus have had the whole work to do 
over again. 

It is not to be forgotten that in plague one imprudent act, 
either of mismanagement in those who are entrusted with the 
executive arrangements, or by an open or clandestine violation 
of the laws of health, incalculable mischief may ensue, and the 
disease be spread far and wide. Thus, if persons performing 
quarantine in a time of plague arc liberated before their state 
of health is sufficiently proved, or care has not been taken to 



ITS INTRODUCTION AND PROGRESS. 



183 



have their effects duly purified, the disease may be reproduced 
on their return home, at a time they least expect it. Cepha- 
lonia became impested in 1816 from some neglect of this kind 
at the quarantine establishment there. It was not fully known 
that the plague existed in Albania on the opposite coast, 
and the quarantine regulations there were little more than 
nominal. 



o 2 



PART IV. 



PLAN OF MANAGEMENT IN THE PLAGUE OF 
LEFCHIMO. 

CHAPTER I. 

Concentration of the sick and suspected — The district divided into compart- 
ments, and no intercourse allowed between them — Mischief arising from 
not attending to the regular shutting-up of camps — Medical inspections 
in the impested villages — The people unwilling to submit to them — In 
ordinary indisposition, the people allowed to remain in their houses, and 
receive medical attendance there — Good effects of these measures — Felons 
employed in duties where there is the most danger — Persons once reco- 
vered from plague not likely to be attacked by it again — Advantages of 
employing convalescents from plague in the most dangerous duties. 

We have seen how widely the disease was propagated in 
Lefchhno, and to what cause its extension was to be properly 
attributed. It now remains for us to detail the plan of manage- 
ment which was adopted, and which so happily led to the speedy 
and complete destruction of the disorder. 

On the breaking up of the army of Genoa, part of the general 
staff received orders to proceed to Corfu in March, 1816, and 
among them were Major-General, now Sir Charles, Phillips 
and myself. On reporting ourselves to his Excellency Lieut.- 
General Sir Thomas Maitland, Lord High Commissioner, 
General Phillips was appointed to the chief direction of the 
plague concerns, and myself to the immediate superintendence of 
the impested district, (thus superseding Mr. Tully, then at the 



PLAN OF MANAGEMENT IN THE PLAGUE OF LEFCHIMO. 185 

head of this duty and senior medical officer) to cany into effect 
there such instructions as I should receive from time to time 
from the Major- General, and to send to him daily a faithful 
account of all transactions. 

The Major-General having been actively employed in the 
late plague at Malta, was particularly well fitted for this impor- 
tant charge ; and I do not hesitate to acknowledge that it was 
owing to his excellent arrangements, and the uncommon zeal 
manifested by all concerned in this undertaking, that the cala- 
mity was so speedily and effectually subdued. 

As a preliminary step to future operations, he directed that 
the pest establishments which had been stationed at Clomo, 
Saint Theodoro, at the convent of SantaTrinita, near Argirades, 
and at Marathea, should be concentrated in one place, on a large 
open space of ground close to the sea, at a distance from the 
villages, as marked in the map, the camp district. This move- 
ment was made with all due respect to the laws of quarantine, 
and also to the integrity of the different classes of persons to be 
removed. A magazine there served for the purpose of an hos- 
pital ; and it is worthy of remark, that in this very magazine the 
smuggled goods which had occasioned all the mischief had been 
put when landed, before they were carried to the Casa Politi, 
the merchant's country residence, and close to the magazine. 
It was situated close to the sea-shore ; and in order to secure 
it, so as to prevent all escape from, and approaches to it, the 
three sides of its square were secured with strong palisades, so 
thickly set, that no one could escape through them ; and only 
the front facing the sea was open. Sentinels were also stationed 
all round this palisading to secure the whole. This place was 
pitched upon for several reasons, but principally for its being- 
insulated and centrical. 

The concentration of these various pest establishments, con- 
sidering the excessive badness of the roads and the inclement 
season of the year, was conducted, under the management of 
Mr. Tully, with as little inconvenience as could reasonably be 



186 



PLAN OF MANAGEMENT 



expected in an operation of the kind, and when once effected, 
was a great point gained. 

On the Major-General's assuming the direction of the pest 
concerns, the plan of arrangement was as follows : — 

First, to bring the contagion of plague into one spot ; 
secondly, to expurgate and purify, and put in a state of 
security, all the villages nearest the principal cordon ; thirdly, 
to insure the future safety of the district by the positive cer- 
tainty that everything which could have remained under the 
ruins and rubbish of the villages originally burnt was carefully 
collected and entirely consumed; fourthly, to find out, and 
either purify or destroy what effects the inhabitants themselves 
had concealed. 

Our opinion on this last point was, that whilst these hotbeds 
of plague — viz., the hoards of concealed effects — remained, no 
security could be reckoned upon. In this manner, we could 
proceed with confidence, and shortly drive the enemy into so 
narrow a field, as to be quite sure of holding him, as General 
Phillips emphatically expressed it, in a letter to me, " not 
merely in check, but positively in chains." 

In order the more effectually to prevent intercourse between 
the impested villages themselves, or between the impested and 
those which were healthy or clean — in short, to put an entire 
stop to people straggling from one part of the country to another 
— the whole impested district was divided into five compart- 
ments, or military divisions, (see the map,) and both the in- 
habitants and the military were restricted to boundaries which 
they were not to exceed ; so that, should any plague break out 
within these, it might be limited to its own proper division ; 
and when it was necessary to send in reports to me, a steady, 
careful soldier was dispatched on that duty. 

This order did not, however, extend to the condannati, and 
the guards appointed to watch over them, who were necessarily 
employed, and whose duties extended all over the impested 
villages, in removing positive or suspected disease, wherever such 



IN THE PLAGUE OF LEFCHIMO. 



187 



appeared, to the camp -district. This, however, was done with 
all due regard to the rules of quarantine ; and as to the con- 
dannati themselves, who were considered only one degree re- 
moved from actual plague-patients, they were never permitted 
to stroll about, or to touch any one else in their way. 

At the time I was appointed to the superintendence of the 
plague-district, on the 23rd of March, fourteen villages were 
either positively impested or highly suspected, from the plague 
having been in them some short time before. These were St. 
Demetri, Clomo, Marathea, Perivoli, Cuspades, Rumanades, 
Neochori Albanase, Argirades, Critica, Ringlades, Anaplades, 
Saint Theodoro, Milichia, and Potami. 

It is true, that in the villages which were considered highly 
suspected the disease had subsided, and, in fact, it did not after- 
wards appear in the upper district. But high suspicion hung 
over them, until their expurgation was completed, and the 
seeds of the disease were thereby removed, which was a work 
of considerable time. And although it was a most happy cir- 
cumstance that the plague did not afterwards appear in the 
villages of the upper district, yet, a priori, no such calculation 
could have been made at the time when the seeds of the disease 
were known to be everywhere scattered over them. 

The following is the general statement of the disease on the 
29th of March, 1816, when I entered on the charge of the im- 
pested district : 

In No. 1, Camp of simply suspected . . .. 217 

— 2, Ditto . . . 142 

— 3, Camp of highly suspected ... 81 
In the lazaretto, sick and recovering ... 90 

Total impested and suspected . . . 530 

Here it is to be observed that there are two classes of simply 
suspected, which it is necessary in this place to explain. 

When General Phillips, a few days before my arrival, gave 
directions to concentrate all the pest-establishments into one 
place, and by one movement to relieve the villages of the sick 



188 



PLAN OF MANAGEMENT 



and suspected, those who had been long recovered from the 
disease, and those under suspicion, who had already performed 
a lengthened quarantine, and were to all appearance in perfect 
health when this general movement and concentration took 
place, were put by themselves for a time as simply suspected, to 
perform an additional quarantine of observation, in order to 
ascertain further that all were free from plague, and until time 
was afforded for the expurgation of their houses. Into this 
camp no new admissions were received. 

No. 2 Camp also contained the class of simple suspicion, and 
consisted of those whose period of quarantine had not been so 
far advanced as in the former class — who, in short, were not so 
free from suspicion. Into this camp the daily admissions of 
simply suspected were received, until a final stop was put to them 
when I saw the mischief that was going on, by the continual 
fresh admissions into it, whereby the period of the quarantine 
of the first admitted was not only retarded, as I have already 
mentioned, but as the plague had shown itself in that camp, I 
was fearful lest it might spread among these unfortunate people. 
All that could be done in this case, when the disease actually 
showed itself, was to remove the sick to the lazaretto, and the 
others in the same tent, or those who I could learn had had 
intercourse with them, to the class of highly suspected in that 
camp, which was always immediately done, and prevent any 
further admissions into it, as every fresh admission in a certain 
degree vitiated its previous character, and rendered the people 
more liable to be impested. I therefore opened a fresh division 
of the same class, and received the admissions into it; and 
after a short time, I also closed it in like manner, opening 
another as often as necessary. 

The same arrangement was carried on in the highly suspected 
class, whose character was equally liable to be vitiated by fresh 
admissions. It is true that the great body of plague is sup- 
posed to exist among this class ; but it is very obvious that 
there is additional risk and danger from every new admission 



IN THE PLAGUE OF LEFCHIMO. 



189 



into it ; and consequently this danger is to be obviated by pre- 
venting admissions after a certain number of days. 

The attention to this matter, so simple in itself, yet so highly 
important, is never to be neglected ; for if the arrangement is 
not made quite clear, we shall remove the disease from where 
it is raging, to be sure, but in doing so, we shall carry it amongst 
persons whose state of health after a certain number of days 
may be considered as free from plague, and consequently put 
them in the way of danger, which by a little good management 
may be avoided. (See Preliminary Discourse.) 

Although positive plague and suspicion were now transferred 
from the villages and towns to the camps, yet it became neces- 
sary still to watch over the inhabitants that remained in them, in 
order to lay hold of anything which might start up afterwards, for 
we had still a dread hanging over our heads from the concealed 
effects ; and with this in view, the usual medical inspections were 
continued in the villages. Had plague appeared among them, 
which fortunately it did not in Upper Lefchimo, we should have 
been sadly thrown back. Our intentions in all these proceed- 
ings were fully explained to the people ; and they were given 
to understand that exact compliance with the orders was ex- 
pected, and would, if necessary, be enforced. 

At first, the people were unwilling to submit to these daily 
inspections, which they thought a great hardship, and not 
necessary — at least, to the extent insisted on ; but they were 
no judges of the matter, and of course their remonstrances on 
the subject were not to be attended to ; and we almost invari- 
ably found, that where there was that unwillingness to submit 
to these inspections, there was some cause or other for suspicion, 
which it was necessary to probe to the bottom. Some were so 
very refractory in this respect, that they declared they would not 
submit to inspection ; but on being informed that they would 
in such case be sent to the camps as suspected if they 
persisted in their obstinacy, they at length yielded. Indeed, it 
was necessary on some occasions to resort to this mode of 



190 



PLAN OF MANAGEMENT 



punishment for their irregular and improper conduct ; and after 
a time they were permitted to return to their homes. 

In cases of ordinary indisposition, in which there was no 
reason to suspect plague, the people were of course allowed to 
remain in their houses, where the medical officers gave them 
the necessary advice, and supplied them with whatever medi- 
cines were proper for their complaints. 

By these vigorous measures, the villages were entirely cleared 
of plague in the course of six weeks from the time they were in 
full force. I find, on reference to the daily returns, that the 
last case of positive plague from the villages was from Ana- 
plades, in Lower Lefchimo, on the 6th of May. 

The medical inspections, and the immediate separation of 
those actually labouring under plague and those suspected from 
each other and from the community, were, as might be expected, 
attended with the happiest results ; no time being thus allowed 
for clandestine intercourse to take place, which, with all possible 
precautions to prevent it, is still to be dreaded, unless these 
measures are promptly resorted to. However carefully sentries 
may be stationed, and houses secured with bolts and bars, yet 
the former may at times be negligent of their duty, or may be 
influenced to swerve from it by a bribe or from other motives, 
and the latter may by some means or other be forced or evaded. 
It is therefore essentially necessary that both the classes should 
be weeded out in the way I have mentioned as expeditiously 
as possible, and placed where they cannot, or at least ought 
not to, do any harm. We are then sure of them, and of the 
utter impossibility of their doing any mischief, at least, beyond 
the quarantine in which they are placed, which would never be 
the case were they not to be removed. 

The service of expurgation and that of attending upon the 
sick being both in themselves exceedingly dangerous, it is very 
desirable in every way, not only that the sacrifice of human life 
should as much as possible be spared, but that the mortality 
should fall on those who are the most unworthy. With this 



IN THE PLAGUE OF LEFCHIMO. 



191 



view, felons, or those who by their crimes have forfeited their 
lives to public justice, but have had them spared, are almost 
always chosen for this forlorn and unhappy service ; and it has 
generally been agreed upon, as an inducement to these unfor- 
tunates, that if they behave well, and survive this service, they 
should not only have their liberty, but be rewarded for their 
good conduct. 

It has been remarked, both in ancient and modern times, that 
those who have once passed through the disease are less liable 
to be attacked by it again ; and this remark has been so well 
established, that some have gone still further, and imagined that 
having once recovered from plague, they are ever after invulne- 
rable to its influence, and may therefore with impunity do what 
they please, either with regard to plague-patients or impested 
goods. This, however, is not found to be strictly correct ; but, 
on the contrary, it is proved by experience that persons who 
have recovered from this calamity are not only liable to it again, 
but that some have been attacked by it twice ; and if we are to 
credit accounts, sometimes oftener, even in the same season. 
Yet these cases are so extremely rare, that we do not hesitate 
to say, that one who has once fortunately escaped with his life, is 
not likely to be attacked a second time during the same plague 
season, and that if he is, it will most probably not affect his life. 
I have not, however, seen any such cases. 

Hence the necessity of getting convalescents from plague for 
these dangerous duties ; and many of them, on being well 
paid, will be found to volunteer their services. The doing so 
is an act of humanity to others, who must of necessity be em- 
ployed if convalescents are not to be found, and consequently 
prevents the mortality, which it is always the chief object to 
avoid. 

It unfortunately happens, however, that convalescents are 
not to be had at the beginning of plague, nor, indeed, till after 
some considerable time has elapsed. Yet even in this case, if 
I could find persons who have had the disease, even although it 



192 



PLAN OF MANAGEMENT 



might have been years before, I would employ them in pre- 
ference to others who have never had it, from the same motives 
of humanity, conceiving the risk to be far less in the one case 
than in the other. But when none such can be found, there is 
then no other alternative in the first instance but that of em- 
ploying such persons as we can get, whether they be felons or 
others. In the expurgation of Lefchimo, we were materially 
assisted by the convalescents, who volunteered their services 
for a dollar a day, and thereby expedited that important 
operation. 



CHAPTER II. 

On expurgation — Examination of the impested houses — Purification of the 
impested houses — Removal of the depots of impested things to a general 
depot — Valuation of the effects sent to this depot — Burning of the depot 
resolved on — And carried into execution. 

The service of expurgation is no doubt attended with danger ; 
but if proper care is taken, that danger is greatly diminished. 
Thus, the people ought to wear oilskin gloves and tarred 
dresses ; and instead of using their hands, on all occasions they 
should use iron hooks or long pincers in the removal of the 
things. They should also rub themselves with oil. But the 
truth is, that these careless and hardened vagabonds can seldom 
be prevailed upon to use any such things, and are apt to spurn 
all advice and to set at nought every precaution. 

I may mention, by the way, that in the selection of those 
men, no one ought to be taken who is not perfectly healthy, 
and strong, and capable of enduring considerable personal 
fatigue. It will be well, also, where there is any choice, to 
have some regard to character, as far as we are able to do so. 

The number of expurgators must of course depend on the 
extent of the calamity, and they should be divided into squads 



IN THE PLAGUE OF LEFCHIMO. 



193 



or parties of eight or ten each, and placed under the charge of 
some person conversant in this duty, who is to be held re- 
sponsible, not only for their good conduct, but also for their 
proper execution of the service ; and when the whole service is 
finished, they must undergo the same scrupulous purification 
as if they had just quitted a plague-hospital. 

The expurgation of Lefchimo was under the direction of two 
gentlemen who had been employed on that duty in the plague 
of Malta — Signori Mazzenti and Azopardi ; and the satisfactory 
manner in which it was executed reflects the greatest credit on 
them. 

It was at first intended that the expurgation should be car- 
ried on at both extremities of the district at one and the same 
time, and proceed on gradually towards the centre, which was 
the camp district, at a distance from all the villages, and close 
upon the sea. But the want of a sufficient number of expur- 
gators for this purpose, and the various other duties which those 
employed had to perform, prevented that plan from being- 
carried into effect. It was therefore determined to employ 
this whole force in the villages of the upper district first, and 
when these were cleared, and found to be so on inspection, 
they were to proceed with the same operation in the lower, where 
the same plan for rooting out the seeds of the malady by ex- 
purgation and the removal of the depots, as in the upper, was 
carried into effect. 

It was the duty of the above-mentioned gentlemen to report 
to me, as superintendent, the progress they made daily, and the 
occurrences which happened ; and I gave them distinctly to 
understand that it was to them I looked for the entire destruc- 
tion of the seeds of plague in every part of the district ; and as 
often as they reported to me the villages which had been ex- 
purgated, it became my duty then to see that it really was so, 
by examining minutely every house, and, in short, every spot 
where plague had existed, to see that the places were well 



194 



PLAN OF MANAGEMENT 



white-washed, fumigated, and ventilated ; that they were per- 
fectly clean, and that no rags or things of a susceptible nature 
remained in them, or were lying concealed about them. 

In these minute examinations of the impested houses and 
places, I directed these gentlemen to enter them before me, 
conceiving that had there been any danger either from imper- 
fect expurgation or want of proper ventilation, they themselves 
would be, as, indeed, they ought to be, the first to suffer from 
it ; and if they had hesitated to do so, I should have then sus- 
pected that all was not right, and consequently have had the 
matter cleared up to my perfect satisfaction before making my 
report to government. Previous to the framing of this my re- 
port, General Phillips had called my particular attention to 
the minute examination of outhouses, wells, staircases, cellars, 
and where there were any appearances of fresh-built walls, 
where the ground appeared to be newly dug up in gardens and 
other places, as in the plague of Malta, where he had so much 
experience in these matters, he had seen quantities of concealed 
articles disposed of in this way after the expurgation had been 
reported to be completed. Being fully satisfied that the ex- 
purgation was perfectly executed, (and here I may remark, that 
had I not been so, I dared not to have misled the government 
in a matter of such high importance, which might have been 
the cause of incalculable future mischief, and have brought dis- 
repute on the system we were carrying on,) I sent in my report 
as to Upper Lefchimo on the 25th of April, preparatory to the 
return of the people in the camps belonging to the villages, and 
to the issue of the proclamation for allowing pratique to the 
people within their respective villages only, which was now about to 
be permitted, they having been all upwards of forty days free 
from plague, and no suspicion of it now remaining amongst 
them. 

Whilst the work of expurgation was going on throughout the 
whole district, attention was also paid to the purification of the 
non-impested houses, or those where the plague had never 



IN THE PLAGUE OF LEFCHIMO. 



195 



appeared, all of which were directed to be well white-washed 
and cleansed by the inhabitants themselves. This might not, 
perhaps, have been absolutely necessary, but it could do no 
harm, and was very much required, as a matter at least of 
cleanliness. 

These non-impested houses were not inspected by me, al- 
though my report stated that they had been purified as directed. 
The magistrates of the villages were held responsible for this 
order having been complied with ; and on their official reports 
to me, mine were framed for the government. The General, 
in his dispatch of the 30th of April, had explained to me, that 
unless the non-impested houses were purified, pratique could 
not be granted. But, in fact, every place was so well cleaned, 
white-washed, and ventilated, that there was not the least risk 
or danger, and I reported the same to head-quarters. 

I myself made the inspection of the whole of the upper dis- 
trict with the exception of Critica ; and as I had stationed Mr. 
Tully, surgeon to the forces, in the lower district, I desired him 
to make the same inspection there, and also that of Critica, 
when they were all reported to have been finished by the two 
chief expurgators. 

My own duties at the time were so numerous, that it was 
impossible for me to go down often to examine the state of 
the expurgation ; and in Lower Lefchimo, indeed, it was quite 
unnecessary for me to do so, as Mr. Tully was on the spot, and 
could look after the business. Besides, his daily reports to me 
were so satisfactory on that point, that I seldom had occasion 
to interfere. Special reports from the two chiefs of the expur- 
gation I generally transmitted to head-quarters without com- 
ment. It was, however, incumbent on me to examine every- 
thing in Lower Lefchimo as I had already done in the Upper 
part of the district, before I could recommend free pratique to 
be proclaimed. 

I have here spoken of the purification of the impested houses 
and the destroying of the seeds of the disease wherever they 



196 



PLAN OF MANAGEMENT 



existed all over the district, but it is not my intention to enter 
particularly into the operation of the expurgation of impested 
things, which can only be executed by those who are accus- 
tomed to it. 

I have said above, that in the plague villages, depots were 
formed, to which the impested goods were removed. These 
depots were generally in some of the parish churches, as during 
the time all religious meetings were suspended ; and it was of 
the very first importance that the goods should remain undis- 
turbed and perfectly secure. They were therefore placed under 
the immediate charge of the military officers commanding in the 
villages, and of the chief magistrates, until their subsequent 
removal. Indeed, all the churches were fast locked up, and 
secured. 

Whenever the purification of the villages was completed, and 
the scattered seeds of plague either collected in these depots 
or burnt, (for it w T ould have been quite absurd to have carried all 
the old worn-out rags into the depot, when they could be so easily 
destroyed at the moment,) it became necessary to turn our 
attention to the removal of them ; for it is very obvious that the 
villages could not be pronounced clean, or free from plague, 
whilst anything positively impested, or even doubtfully so, 
remained in them. 

The principle we acted on here was that of driving positive 
plague, and the seeds of it, into one well-secured depot. 

With the view T , therefore, of carrying this into effect, one 
general depot was erected in the camp district near the pest 
hospital, to which all these intermediate depots were removed. 
And here it is to be observed, that by this time the whole of the 
cases of disease, as far as known, were confined to the camp- 
district ; for the villages had all been expurgated, and all the 
plague contagion removed from the houses. The people them- 
selves were also still confined to their houses.* 

* It is to be observed that I am here speaking of a period antecedent to the 
issue of the proclamation allowing free pratique among the villages themselves. 



IN THE PLAGUE OF LEFCHIMO. 



197 



In order to diminish as much as possible the danger to which 
the expurgators were subjected in the removal of the things 
to this general depot, as well as to prevent the impested goods 
from being scattered about upon the roads, — which would inevit- 
ably have been the case had they been carried in a loose and 
careless manner, — large wooden boxes were sent down, with 
handles on them for poles, to be carried like hospital-bearers. 
Into these tarred boxes the things which were considered to 
be of any value were thrown by means of iron prongs, and the 
boxes when filled being locked up, so that those who carried 
them had no access to their contents, were thus safely delivered 
at the depot, for after purification. This, considering the 
excessive badness of the roads, and the heat of the weather, 
was a very fatiguing duty; but it was happily executed without 
any accident. 

In the construction of this depot, or purifying house, as it may 
be termed, which was built of wood, under the direction of Mr, 
Mazzenti, on the same principle as the one built at Malta for 
the like purpose, care was taken that it should be so arranged 
and subdivided, as that the effects belonging to one village should 
not be blended with those of another, and that they should be 
put into the part marked and set aside for them. When all this 
was finished it was well secured, and placed under the care of 
an officer and a party of the military ; the former being made 
responsible for the conduct of his men, as well as for the safety 
of the w T hole, and entrusted with the keys. This was done on 
account of the danger to be apprehended lest it should have been 
broken into and robbed, and the plague thus spread abroad, 
more than from any consideration of the actual loss of the pro- 
prietors of the articles which might have been stolen. 

Whatever might have been the real value of the effects when 
first carried to the village depots, certainly on their removal 
thence, and being placed in the purifying house, by far the 
greater part was very little worth. 

As Mr. Mazzenti had been employed in directing the removal 



198 



PLAN OF MANAGEMENT 



of these effects, and knew better than any one else their actual 
value, I directed him to make out the best estimate he could of 
the value of the effects belonging to each village ; and also a 
calculation of the expenses which would have been incurred in 
their purification, should Government afterwards decide that 
this should take place. 

Having transmitted Sig. Mazzenti's statement on the subject 
to head quarters, it was ultimately decided by the Government 
that it would not only be much better for the individuals them- 
selves, but for all concerned in the plague duties, if the whole of 
the articles in the depot were burned, and the seeds of plague thus 
completely destroyed at once, by which means all danger from 
their purification would be avoided, and consequently the period 
of free pratique accelerated : the future safety of the island was 
also thus made more secure. There was likewise another great 
advantage to be thereby gained, should no fresh mischief start 
up in the villages of the district, which, by this time, there was 
no reason to fear; and this was, that the whole business would 
be completed before the extreme heat set in, which we had 
serious reason to dread, in some respects as much as the plague 
itself. And, indeed, this apprehension was realized afterwards 
in the malignant fever which broke out among the troops, before 
everything was finally completed : and I have no doubt, had 
any unfortunate circumstances intervened to protract the general 
liberation, and had we been detained longer in the district, the 
autumnal fever would have fallen more heavily on the troops 
than it eventually did, and would have rendered it necessary, 
from the sickness, to relax the strictness of the system that was 
then carried on, the integrity of which it was so highly important 
to keep up ; or, perhaps, have led to the abandonment of the 
system altogether, and consequently thrown everything into 
such a state of confusion as to break down every restriction, 
and in some degree render of no avail all that had been 
done. 

The burning of the depot of infected tilings (formerly consi- 



IN THE PLAGUE OF LEFCHIMO. 



199 



dered an operation not free from danger) was intrusted to Sig. 
Mazzenti, who had performed the same duty in the plague of 
Malta, and was executed without any accident in the following 
manner: Several trenches were dug, over which were laid raf- 
ters of wood and brushwood. The contaminated things of every 
description, to the very minutest rag, which were of a susceptible 
character, were dragged out from the different apartments with 
iron hooks, by the expurgators, and thrown in heaps on these 
rafters ; and fires being kindled at each end of the trenches, 
in a few hours the whole was reduced to ashes.* 

In the depot were a considerable quantity of loose papers, 
and books belonging to the churches. The former were purified 
singly ; and such books of registry as had been saved from the 
general wreck were afterwards cut out leaf by leaf, and placed 
on files after purification, by Sig. Aropardi, one of the chiefs of 
expurgation. It would have been useless to have attempted to 
purify the other books (which might be bought) in this manner, 
as not worth the trouble, time, and expense ; they were there- 
fore consumed. A committee was afterwards appointed to 
examine the loose papers, when those of consequence were 
retained, and the others destroyed. 

I have already said that the inhabitants of Lefchimo were a 
refractory and turbulent race of persons, as the Russians found 
when they were in possession of the Island ; and as we our- 
selves experienced during the time of the plague. They were 
for a long time very desirous of knowing what I meant to do 
with the depot of infected things ; and seemed to have a pre- 
sentiment that as I had now got them in my possession, I 
meant to burn them. I studiously avoided giving them any 
decisive answer on the subject until I had received orders from 
the Government ; for as well in the camps as in the villages, 
were the people clamorous and importunate to know my inten- 
tions ; so much so, that some of the villages were reported to 

* Thus it was proved that impested things could not only be removed, but de- 
stroyed with impunity. 

i»2 



200 



PLAN OF MANAGEMENT 



me by the officers in charge there, to be in a state of consider- 
able insubordination, and some trouble was apprehended. 

I therefore felt it my duty to write to head quarters for in- 
structions in the matter, and next day received a reply marked 
confidential, putting me on my guard against saying anything 
decisive on the subject for the present, but that I should soon 
receive my orders ; that it was the intention to burn everything, 
but that I must keep this a profound secret, until everything 
was ready, for fear lest this refractory people should give us 
trouble. A letter was also written by the Adjutant-General to 
the officers in command to the same effect, desiring them to 
have their men ready in case of tumult amongst them. I soon 
afterwards received my instructions to burn the depot, and 
desired Sig. Mazzenti to carry it into effect that same night. 

When the inhabitants saw the cloud of smoke the next mor- 
ing, they were in a violent rage, threatening every one concerned 
with vengeance. I went down shortly afterwards to the camps 
to see the people there, and subsequently visited the villages, 
and found them in a state of considerable excitement ; but on 
my telling them that by having burned the infected things, the 
period of their misery would be shortened ; that it was necessary 
to prevent a return of the dreadful calamity ; that the great part 
of their effects were of little value, and cotton, and not worth 
the trouble and expense of purification, which they themselves 
would be obliged to pay for ; and finally pledging myself on the 
part of the Government that they should receive indemnification 
for their loss ; I at length succeeded in pacifying them. 

Conceiving there was no necessity for destroying the building 
itself, (which was constructed entirely of wood,) together with 
the impested articles, I told Mr. Mazzenti that I thought he might 
be able to burn the effects, and yet preserve all the wooden work, 
which could be afterwards applied to other purposes, and this 
without any additional risk to the persons employed, if only 
proper care was taken. He entirely concurred with me in this 
opinion, and the whole of the wood was thus preserved. It was 
thrown into the sea for a time, and afterwards made use of. 



IN THE PLAGUE OF LEFCHIMO. 



201 



The delicate operation of burning the things in this general 
depot was accomplished without any accident; and the same 
operation in a more partial degree was executed frequently 
in the villages with equal success, when no other precautions 
were used but those of avoiding contact with the impested 
things, and of keeping to the windward while these were burning, 
which, indeed, was indispensable, in order to avoid being suf- 
focated with the immense cloud of smoke issuing from them. I 
am therefore bound to consider as merely fictitious those stories 
we have read of contagion spreading in the air, and causing the 
sudden death of those employed in burning the impested goods. 
That such persons may have suffered, I readily admit, but it 
was certainly from handling the impested articles, and not from 
any contagious matter flying off from the air, and impesting 
the people. Indeed, I am warranted in affirming, from the fre- 
quency of our burning impested things in Lefchimo, that this 
may always be done with the utmost safety, if the people do but 
avoid all contact. Were I allowed to hazard an hypothesis on 
the subject, I would say that the contagion is destroyed, or 
rendered quite inert by the heat, and cannot thus contaminate. 

The impested places having therefore been all expurgated, 
the depots in the villages removed, and the seeds of plague de- 
stroyed by burning the general depot, two things still remained 
to be done, before the villages or the country could be pro- 
nounced quite clean, or the future security of the public health 
be considered fully established. The first was the thorough 
expurgation of the churches, several of which had been used as 
depots ; and the second, the securing of the graves, where those 
who had died of plague were buried. 



202 



PLAN OF MANAGEMENT 



CHAPTER III. 

Expurgation of the Churches — Securing the plague graves — Concealed effects 
— Rewards granted for their discovery — Duties of the Medical Officer in 
charge of the camps, or places of segregation — The length of time plague 
contagion may remain in the system without showing itself. 

The calamity in the first instance had been so widely propa- 
gated by means of the clergy, that both they and the churches 
became objects of the most serious consideration. The priests, 
like the rest of the inhabitants, had been confined to their 
houses, and the churches shut up for a considerable time, no 
congregations of the people having been allowed on any pre- 
text whatever. 

As soon, therefore, as the impested effects were removed from 
the churches, we turned our attention to the expurgation of the 
whole of them. From their immense number, scattered as they 
were all over the district, this was no easy task to perform ; for 
I observe, on referring to the returns of expurgation, that they 
amounted to no fewer than 89 ; all of which it was thought ne- 
cessary to purify. It is to be observed, however, that for the 
most part they were small miserable places, little better than 
huts. 

In the first ebullition of the malady, and before it was pro- 
nounced to be plague, the people were buried, not only in the 
usual burying-places, but also in the churches, and in the very 
houses where they died ; in the neighbourhood of the villages, 
and in the fields. The utter impossibility, therefore, of ascer- 
taining the real state of these graves, and whether or not the 
dead bodies had been deposited at a proper depth, added to the 
fact that many of these bodies had been buried in their impested 
clothes, caused among us for some time a considerable degree 
of uneasiness, lest by any accident these graves should be 
opened by the people, as some of the buried persons were sup- 



IN THE PLAGUE OF LEFCHIMO. 



203 



posed to have valuable things about them, and thus cause the 
disease to start up afresh. This uneasiness was increased from 
the fear that the wild dogs,* that abounded in the district, 
would tear open these graves, and, by some means or other, re- 
produce the disease. The securing, therefore, of these graves, so 
as to prevent the possibility of such accidents, was an object of 
immediate necessity ; and, waving all speculations on this head, 
I give it as my opinion that it is not safe to touch or interfere 
with a pest body, whether wrapped up in clothes or not. Possibly 
after a certain time it may cease to be noxious, but that is not 
known ; and I hold it to be an act of temerity to put the matter 
to the test, the more particularly as it can never be necessary 
to do so. 

In order to have Messrs. Mazzenti and Azopardi's opinion 
upon the subject, I consulted them on the propriety of re- 
moving these bodies, when they both gave it as their most decided 
opinion that such a step could not be taken ; that it was not to 
be attempted, and that they would have nothing to do with any 
operation of the kind. These were, indeed, exactly my own 
sentiments. 

It is very remarkable that in almost all the civilized world the 
same dread of touching the cemeteries of those who have died of 
the plague has prevailed, from the evident apprehension of re- 
producing this most terrible calamity. Even among the 
Cossacks in Russia this dread was so great, that Mr. Clarke 
was prevented from opening a tumulus, for fear lest those 
who were therein deposited might have died of plague, and 
might, if interfered with, communicate the disease to them. 
(See Clarke's Travels in Russia, vol. i. page 269.) 

The plague graves were secured by the expurgators, under 

* I remember that in Egypt, during the time I was employed in the 
plague there, such a circumstance as this actually happened ; for several of 
the bodies buried the evening before were dug up by the jackals or wild dogs 
during the night, and their mangled limbs were found scattered among the 
tents on the following morning. 



204 



PLAN OF MANAGEMENT 



the directions of the two chiefs, in the following manner, which 
was, indeed, all that could be done at the time. As much of the 
earth was removed from them as was considered prudent ; a 
quantity of quick-lime was then spread over the graves, which 
were afterwards filled up with earth, and pressed down ; over 
this loose stones were placed, and a small wooden cross was 
erected, to denote a plague grave. It was the intention after- 
wards to erect proper grave-stones, with an inscription on 
each in modern Greek and in Italian, stating it to be a plague 
grave, and not to be meddled with. Whether this was ever 
carried into effect I know not ; but it was not done during my 
stay in the island. 

In the churches where the pest bodies were interred, and 
which, I think, amounted to six, I recommended that before they 
were used for divine worship, proper grave-stones should be 
sent down for them, which was complied with before I left the 
district. 

Another most unpleasant circumstance tended to keep us in 
a constant state of alarm for some time; it was our knowledge 
of the fact that impested articles were still concealed in various 
parts of the district. 

Although every possible precaution was taken to prevent 
persons from having access to those nests of plague contagion, 
it was still to be feared that the cunning Greeks would find 
some means or other of evading our precautions, and, in going 
to look after their articles, might bring back with them the 
seeds of the disease. Indeed, I have reason to believe that the 
disease started more than once in lower Lefchimo from this 
very cause : nor was it only the immediate breaking out of the 
disease whenever these hoards were interfered with that we had 
to dread, but also its re-appearance afterwards, at an unknown 
period, when the people, who were now confined to their 
houses, would be free from all restraint ; or when those who 
were in the camps would have returned to their homes, after 
their liberation, as it was naturally to be expected that, as soon 



IN THE PLAGUE OF LEFCHIMO. 



205 



as they were able, they would go to look after and bring home 
the things they had concealed. 

The measures now in force were such as enabled us im- 
mediately to suppress the disease, should it re-appear ; but it 
was impossible for these always to remain in vigour, or for us 
to be always watching the plague in this manner ; and the very 
idea of a want of perfect security, after all that had been done, 
and the bare possibility of the disorder breaking out again 
(owing to the causes mentioned) at some future period, when 
all restrictions would be removed, was far from pleasant. 

I have already, in the Introduction, touched on this matter, 
but I find it still necessary to enlarge a little upon it here. 

A reward having been offered by Government for the dis- 
covery of concealed articles, several persons then in the camps 
came forward to tell where they had hidden various things, and 
wished for permission, under an escort, to go and show the 
places of concealment. This, however, could not be done at 
the time, but was done afterwards ; for had they then gone to 
the villages from the camps to look after their things, before the 
time they were proved to be free from plague, some communi- 
cation might have taken place betwixt them and their friends, 
by which means the villages (which, for a considerable time, had 
been free from plague, and were also expurgated) might thus 
have become again impested from the camps, where the malady 
was still breaking out occasionally. 

All that could be done in the meantime, therefore, was to get 
from the people the most accurate description they could give 
of the places where the articles were hid ; and, with this in- 
formation, a party of expurgators were sent to the different 
spots to search for them. Sometimes the expurgators had no 
difficulty in finding out the things from the descriptions given 
of them. At other times, the articles were not discovered till 
long afterwards. On their discovery, however, a compensation 
was immediately granted for them, and whatever was of a sus- 
ceptible nature among them was burnt on the spot. On the 



206 



PLAN OF MANAGEMENT 



breaking up of the camps, when the people were suffered to 
discover their remaining hoards, they were not themselves 
allowed to touch them ; they merely pointed them out to the 
expurgators, who did with them as they were directed. 

No doubt but the people in the camps might have been per- 
mitted, under an escort, to go to the villages to point out the 
places where they had concealed the things ; but it is to be re- 
membered that plague was still lurking in the camps, and 
starting up occasionally, whilst the villages were free from it, and 
had been expurgated. Moreover, we had no troops to spare for 
these duties. It would therefore have been running too great 
a risk to do this, which it was best to avoid ; for there was no 
saying what friends and relations, who had been long separated 
from one another, and who perhaps were ignorant of each other's 
fate, might have done in a moment of joyful transport at 
meeting; and it would have been dreadful and shocking to 
humanity to have put the punishment awarded for a breach of 
the laws of health in force against these poor people. It was 
therefore much better to keep the classes distinctly separate, as 
they were, for a time. 

Many of the things thus found out were perfectly rotten and 
useless, from the length of time they had remained under 
ground ; but even in this case some compensation was given, 
as an inducement to the people to come forward and confess 
to everything they had secreted: and all articles of gold or 
silver that were discovered, were returned to them at the time, 
on their being purified, in order to convince them that we had 
no wish to keep back from them any part of their property. 

The expurgators frequently discovered by chance, quantities of 
concealed effects among the brushwood, and in various places, 
which they forthwith, and without any ceremony, destroyed on 
the spot. In these cases, no indemnification was made to the 
owners ; such only being deemed worthy of compensation who 
had made known their concealments. It was proper to make this 
distinction, in order to prevent the generosity of Government 



IN THE PLAGUE OF LEFCHIMO. 



207 



from being misapplied, and to induce the persons concerned to 
reveal these nests of plague which were so much to be dreaded. 

Among those who came forward to confess to concealed effects, 
was a poor woman, then a patient in the hospital. She stated 
that when first taken ill, and before she was sent to the hospital, 
she had hidden some money wrapped up in a towel, in a certain 
part of her house, which she described. She was, of course, 
commended for the discovery, and it was promised that the 
money when found should be restored to her. Search was 
therefore made for it, but it could nowhere be found, and it was 
thought that she might have been confused at the time, and 
incapable of knowing what she did. She, however, persisted in 
her story, and described with considerable minuteness the 
precise spot where she had placed it. Mr. Gemmilaro, to whom 
she had made this confession, took a drawing of the house and 
premises from her description of them, and marked the spot 
where she said the money was laid up. It was then found 
wrapped up in the way she had mentioned. 

I was uneasy until this discovery was made, not so much on 
account of the money itself, as of the towel it was wrapped up 
in, which there could be little doubt was impested. The towel 
was taken hold of with iron pincers, and burned, and the money, 
being purified in vinegar and water, was restored to its lawful 
owner. 

I have been supposing all along that the people in quarantine 
are encamped, and not in houses. But whether this be the case 
or not, every regulation concerning them should be conducted 
on the same principle. 

The medical officer in charge of the camps must keep a 
register of all the individuals sent to quarantine and observation, 
containing their names, ages, the places from which they come, 
and the particular reasons for which they are sent to the camps, 
whether highly suspected or on simple suspicion. He must also keep 
an exact account of all transfers from the class of simply suspected 
to that of high suspicion, and from either of these classes to the 



208 



PLAN OF MANAGEMENT 



hospital, or pest house, and also of the cases of suspicion which 
turn out afterwards to be plague. The dates, too, are to be 
correctly recorded ; for it is only by them that we are enabled to 
make any calculation of the state of health of these quarantines. 
It is of course to be supposed that a regular return of all the 
admissions into, and deaths which happen in the hospital, and, 
as far as can be done, a detailed account of the cases themselves, 
be kept by the medical gentleman in charge of that special 
duty. 

Another very important duty of the medical officer in charge 
of the camps is, to take care that whatever effects of a susceptible 
nature the people may bring along with them be carefully puri- 
fied, so that if plague contagion exists in any of them it may 
be destroyed, and not break out afterwards when they come 
to be handled or worn by their owners after their liberation 
from quarantine restraint. If there is any plague contagion in 
articles, it is proper to bring it out of them while the people are 
performing their quarantine, for we thus meet the enemy on our 
own ground. . 

I ought not to omit mentioning a circumstance which occurred 
in one of the camps in Lefchimo, as bearing in some degree 
upon this point. 

Among those sent to the camp as highly suspected was an old 
woman from Potami, who, among other things which she had 
brought with her, had some cotton, which she intended to spin 
during her quarantine. Somehow or other she had contrived 
to secrete this cotton when her other things were washed in 
the sea, according to the standing orders of the camp, thinking, 
I imagine, that it would be injured by the salt water. 

For eight days after her admission into the camp, she conti- 
nued to all appearance in perfect health. On the ninth day 
she began to work at her cotton. Soon after she grew sick, and 
died of the plague after two days' illness. I own it is possible that 
she might have had the plague in her system before her coming 
to the camp, from her living with a family at the time they were 



IN THE PLA.GUE OF LEFCHIMO. 



209 



attacked by it ; and her being so, was the reason for sending her 
to the camp, as highly suspected. But the impression on my mind 
is, that the fomes of the plague was in the cotton, and that on 
her beginning to work it, she fell sick. 

I think it would be an improvement in the internal manage- 
ment of camps, or of establishments on the same principle, if 
some more speedy method were adopted of destroying the con- 
tagion, than the slow one of airing and handling, or even of 
immersing effects in cold water; and I am of opinion that this 
might be effectually done by steeping the things in hot water for a 
short time ; and if fresh clothes could be given to the persons ad- 
mitted, particularly to those under high suspicion, as soon as they 
are received, it would be desirable to put all their effects, includ- 
ing the clothes they had on, into caldrons or tubs of hot water, 
either with or without soap. This, I conceive, would at once 
entirely destroy whatever contagion was in them, and with it 
all the dread of plague afterwards ; so that if the seeds of plague 
happened not to have been already in the system or constitution 
of the persons, they could not get the disease either from their 
body clothes, or from the articles they had brought along with 
them. Moreover, it would diminish the usual period of qua- 
rantine, which on every account is so desirable. 

It is, however, proper for me to remark, that in the plague of 
Corfu, the purification of the effects of the persons in the 
camps was not done in this manner, from our want of the 
means of doing so. They were only repeatedly put into cold 
water, and dried in the air ; but the more I reflect on the matter, 
the more I am convinced that, for several reasons, it would have 
been much better to have put the things into hot water; for if 
this had been done, the poor woman from Potami, mentioned 
above, might have escaped. 

Before these fresh clothes are put on, and indeed before they 
are touched by those for whom they are intended, it would be 
well if their bodies were washed with soap and water. Their 
own clothes could soon be dried, and might then be worn without 



210 



PLAN OF MANAGEMENT 



any danger. But the fresh clothes with which in the meantime 
they are supplied, ought not, after their wearing them, to be given 
to others, until they are purified in the manner stated, lest they 
should have become impested by those who had previously worn 
them, supposing such to have been attacked by the plague 
before a period of fifteen or twenty days had elapsed from that 
of their admission. 

I doubt whether merely once putting the things into cold water, 
and then drying them, would effectually destroy plague conta- 
gion, but I have no doubt that the doing so three or four times 
would completely destroy it. Still I am of opinion that the 
safest mode will be the immersion in very hot water. 

On consulting Sig. Mazzenti on this subject, he gave it as his 
opinion that one immersion in cold water was not safe, and that 
he would not trust to it. He agreed with me in thinking that 
hot water, used in the way I then mentioned, is the most effectual 
mode of purifying. Our plague tents, that were considered worth 
the trouble, were purified by repeatedly immersing them in the 
sea, and then freely exposing them to the weather for a consi- 
derable length of time : they were then put by for use. 

It will unavoidably happen that many of the things thus puri- 
fied will be injured by the process ; but when the great object, 
that of immediately destroying any plague contagion that 
they may contain, is taken into consideration, and of thereby 
getting rid of all risk and danger from that moment, there are 
few, I imagine, who would put the loss in competition with 
the advantage arising from it, or who would hesitate for one 
instant which to adopt. But, indeed, this matter ought not 
at all times to be left to the people's own decision, as it is not a 
case in which the proprietors alone are concerned, but one in 
which the public health is deeply interested. 

It may be alleged, however, that of the multitudes whom it 
may be necessary to send to quarantine or observation from 
time to time, not many are found to have the plague eventually, 
and that the danger of their effects being impested is not so 



IN THE PLAGUE OF LEFCHIMO. 



211 



much to be dreaded as is supposed ; that it is not, therefore, 
necessary to injure these by purification. To this I reply, that 
had we any means of positively ascertaining what things are 
really impregnated with the plague miasma and what not, I 
would decide at once on the things to be destroyed or to be 
purified, while the others remained untouched. But as we 
have no way of knowing that fact, we are not to trust to chance 
in this matter when we have an effectual remedy in our own 
hands. It is better for the owners themselves, not only that 
their effects should be injured, but even that they be utterly 
destroyed, than that they themselves should run any risk, or be 
subjected to such dreadful anxiety respecting their future state 
of health as that which they must endure until a considerable 
period of time elapse, and which is inevitable, should they ex- 
pose themselves to become impested by airing and purifying 
their own clothes and property in the usual slow way, rather 
than trust them to be purified by the expurgates. 

The plan I have here proposed may by some be considered 
as chimerical, and difficult to be accomplished, and I know 
that it must be attended with considerable trouble. It is not 
my business, however, to consider these difficulties in this 
place, or the expenses attendant on such a work ; for the 
management of plague is not only accompanied with danger 
and difficulties, but also with incalculable trouble, and very 
serious expenses at all times. It is my duty here only to con- 
sider and detail the means of destroying the contagion of plague, 
and to secure the public health, without entering on the consi- 
deration of other matters. 

It will be observed, that I here suppose the persons under 
suspicion to be perfectly free from plague in their constitution 
at the time, and the possibility of their being impested after- 
wards from their clothes, or from purifying their other effects. 

I have, in another part of this work, mentioned that the period 
of time during which the seeds of plague may remain in the 
system without showing themselves does not usually exceed 



212 



PLAN OF MANAGEMENT 



twelve or fifteen days ; and I remember General Phillips telling 
me, that in the plague of Malta, where he had good opportunities 
of knowing this matter, he never knew but one case in which 
the plague in the constitution did not show itself till the thir- 
teenth day, and that this case was as well ascertained as such 
things can be, although it was still possible that in this instance 
the disease was occasioned by contact of a later date than was 
supposed at the time. He added, that it is rather rare after the 
tenth day. Seventeen days, however, is, I believe, a period 
beyond which the disease has never been traced to break out 
in the person of an individual who has been rigidly separated 
from every one, and as rigidly made to perform the airing and 
handling of his clothes. 

But lest the disease should remain in the system beyond 
seventeen days, either from peculiarity of habit or any other 
circumstance, I would increase the period to twenty days, in 
order to be as sure on this point as in a case of the kind we can 
be. For my belief is, that if the plague is in the constitution, 
it will show itself before that time. The prospect of the people 
would then, after this probationary trial, become more cheerful, 
as this horrible dread of plague hanging over them would then 
be quite removed. They must naturally feel very anxious till 
that period is over, but afterwards that anxiety will cease, and 
they may look forward with joyful anticipation to their libera- 
tion from restraint, which in no case should exceed the term of 
forty days — nay, which with perfect safety might be consider- 
ably reduced, as I have shown. Yet on this point I would not 
insist, as I am aware of the extreme delicacy of interfering with 
the established laws of quarantine. 

The old system, therefore, of forty days of foul quarantine 
and forty of clean is absurd, cruel, and unnecessary for the pro- 
tection of the public health for persons coming from plague 
countries or places ; and I consider that they may be liberated in 
fifteen days at the furthest from the time they have undergone the 
complete spoglio, if at the end of that time they are in health, 



IN THE PLAGUE OF LEFCHIMO. 



213 



(always premising that they have carefully purified their effects 
whilst in quarantine,) particularly if they have been healthy 
during the voyage and at the time, which is to be declared when 
they are examined by the inspector of health. 

Whilst on this subject, I may mention, that in Corfu I could 
never learn any well- authenticated case of the plague occurring 
after nine days from the last suspected contact, or after persons 
undergoing the complete spoglio ; and we invariably found 
that the trying period was on or before the ninth day. Indeed, 
after that day, my mind was generally easy on the subject. 



CHAPTER IV. 

On camps — The provisions to be placed at a particular spot — Difficulty of 
sometimes ascertaining what property ought to be expurgated and what 
should not be interfered with — Prevailing opinion in Lefchimo concerning 
property destroyed there. 

I generally placed the divisional camps at the distance of 
fifty or sixty yards from each other ; and by way of greater 
security, I caused a broad and deep ditch to be dug, to impede, 
if not entirely to prevent, intercourse between them ; and I 
found the country people who were confined in these camps 
seldom unwilling to be so employed. The operation seemed 
but an amusement to them, who had nothing else to do, and it 
was no doubt conducive to their health. These camps, as I 
observed, were well guarded night and day to prevent commu- 
nication, and regularly shut up against all fresh admissions 
after eight or ten days. 

It may be asked how, as none were allowed to enter these 
camps, the people were to be provisioned, and the inspections 
to be made ? In answer, I have to say, that all their provisions 
were placed at a particular spot outside these camps, and each 
person or party came regularly thither to fetch away their 
allowance. The distribution was made by one of the commis- 
si 



214 



PLAN OF MANAGEMENT 



sariat department, assisted by the camp-guardians, who were 
confidential men employed as police-officers. 

With regard to the medical examinations of these camps, 
this duty was performed by Assistant- Surgeon Gemmellaro, of 
De Rolle's regiment. He was almost constantly walking 
through the camp-lines. At his inspections, the people were 
all directed to retire into their respective tents, then called over 
and examined, one by one, those of one tent after those of 
another, he standing near the door of the tent. All this was 
done without his having any contact with the people, and with- 
out the least risk, as he took particular care that the lines were 
always kept clean and clear of impested things. 

In this laborious and incessant duty I had every reason to be 
highly satisfied with his diligence and zeal during the whole 
time he was performing this important charge, which was 
almost from the formation of the camps till they were finally 
broken up. He merits my best thanks. 

In the first instance, on the breaking out of the plague, several 
families, particularly in Lower Lefchimo, locked up their houses 
and magazines, and fled to different parts of the country. These 
places were reported by the inhabitants who remained in the 
villages to have continued locked up ever since their owners 
had deserted them, a period of several months. 

While the expurgation was going on, the question to be 
decided was, whether these places were to be delivered over to 
the expurgators or not ; for it was quite evident that the vil- 
lages could not be considered or reported free from plague as 
long as there was any uncertainty with regard to them. No 
satisfactory account of the health of their owners could at the 
time be obtained ; nor, indeed, was it even known where they 
were in some instances, or whether the plague had ever been in 
their houses and magazines or not ; whereas if the expurgators 
once entered them, they must, as a matter of course, be con- 
sidered as impested, even though they had not been so at first, 



IN THE PLAGUE OF LEFCHIMO. 



215 



and the effects they contained seriously injured, if not in many 
instances entirely destroyed. 

As property to a considerable amount, (the disposing of 
which was an affair of the government,) as well as the security 
of the public health, was involved in the question, I did not 
venture of myself to decide on the case, but reported it to the 
Major-General, and requested his instructions; upon which I 
received the following directions : — 

To ascertain the names of the persons to whom the houses 
and magazines belonged, and call upon them forthwith to state 
the precise period at which these places were shut up ; to make 
every inquiry into their previous and present state of health, 
and into that of their connexions. Having done so, and ascer- 
tained that all persons concerned were in perfect health, and, 
as far as was known, had never had the plague among them, 
and that no suspicion of plague hung over them, I was 
desired (after the other impested houses in the villages 
were purified,) to call on these proprietors, directing them to 
open their houses and magazines and reside in them as for- 
merly, washing, airing, and handling all the susceptible effects 
they contained. These places, and those residing in them, 
were to be subjected to a short quarantine of fifteen days; the 
houses to be well ventilated and whitewashed under the inspec- 
tion of the military officer commanding, and the chief magis- 
trates of the village, whilst a medical officer was directed to 
inspect the state of health of the inmates daily, to ascertain 
whether any symptoms of plague appeared among them. These 
injunctions were strictly complied with ; and at the end of the 
fifteen days, no symptoms of plague having made their appear- 
ance, their restraint was removed, and free intercourse with 
their neighbours was granted them. By these means, a con- 
siderable deal of property was saved, which, under other 
management, would have been destroyed, whilst at the same 
time the public health was carefully protected. 

Q 2 



216 



PLAN OF MANAGEMENT 



Had the proprietors themselves not complied with this ar- 
rangement, or had they not found others to do so for them, for 
hire, the government would have taken the matter into its own 
hands ; it would have procured proper persons to put in these 
places to prove them, and the whole expense of this would 
have fallen on the proprietors. 

It is necessary here for me to digress a little on the subject 
of property destroyed in the time of plague. The people of 
Lefchimo entertained an idea that government was to make 
good to them all losses arising from plague. How such an 
opinion ever came to be formed I could not learn, but it seemed 
to be a prevalent one all over the district. The people imagined 
that, whenever the plague was over, they had only to send in to 
government a statement of their losses, and receive from it 
the amount. Placed as I was, in the superintendence of the 
plague district, and the medium of correspondence with the 
government, on perceiving that they did not care what property 
might be destroyed, from the erroneous idea that they would be 
afterwards indemnified for it, I immediately gave them dis- 
tinctly to understand that no such compensation as the one 
they expected was ever in contemplation, and that neither in 
law nor in justice had they any right or claim to such. 

It may be the policy of a government at times, and as an 
act of generosity on its part, to grant some remuneration, or 
rather compensation, to individuals, for what things it may be 
necessary to destroy, in order to protect the public health ; but 
it can never be expected that this is to be done on an extended 
or general scale, so as to embrace all the losses which the 
public may suffer. The plague is a scourge, like famine, or 
any other general calamity, and those attacked by it must 
necessarily suffer from it. Their property, in as far as is con- 
sistent with the safety of the community at large, is to be 
saved, by making the proper separation between what is really 
impested and what is only suspected; that the one may be 
destroyed, or purified, if found practicable, and the other care- 



IN THE PLAGUE OF LEFCHIMO. 



217 



fully preserved from injury. The expenses attending the 
management of plague, which are always very serious, fall 
directly on the government. But individuals must expect to 
bear their share in the general calamity. 



CHAPTER V. 

Removal of the people in the camps to their villages — Great difficulty of pro- 
visioning the people — Sir Thomas Maitland's kind considerations for them 
— Necessity of bringing matters to a speedy termination on account of the 
expected remittent fever — The people's houses to be repaired before they 
are sent home- — Some of the persons to be removed, very weak from ordi- 
nary complaints — Minute examination of all the people previous to their 
removal — Necessity of employing civic guards to assist the troops — Reasons 
for subjecting the persons returned from the camps to further quarantine — 
Great joy of the people on being liberated — Further means adopted to dis- 
cover concealed effects — Highly improper conduct on the part of the 
priests — The people who were hitherto shut up in their villages, liberated 
before those belonging to them were sent back from the camps — Period of 
quarantine in the class of highly suspected shortened from forty to twenty- 
five days, that of the class of simply suspected from forty to seventeen 
days — On cases of supposed plague — The difficulty of managing individual 
convalescents from plague — On the pestilential bubo — A place of security 
to be prepared for the performance of the quarantine of convalescents from 
plague — Examination of these previous to their being encamped — Are to 
be well washed and receive fresh clothes — Those of Lefchimo directed to 
give up an}? effects they may have concealed — Amulets worn by several of 
them, to which they attributed their recovery. 

When once satisfied, as far as we could well be, that no plague 
remained in the upper district, whilst in the lower one the expur- 
gation was going on with the whole of our force, we had next to 
turn our attention to the removal of the people now in camps to 
their villages, as their period of quarantine had expired. It 
was necessary, for many reasons, to lose no time in carrying 
this movement into effect ; for although the people had borne 
all the restrictions of quarantine with as much temper as could 
well have been expected, yet all restraint, under any circum- 



•218 



TLAN OF MANAGEMENT 



stances, must be irksome and unpleasant. They were now 
become exceedingly anxious and impatient for their liberation, 
looking forward with pleasing anticipation to the near approach- 
ing period of their return to their friends, and of the enjoy- 
ment of social intercourse with their relatives and acquaint- 
ances. 

Amongst other reasons for accelerating their return, there 
was one of a most cogent nature, which it is proper to mention 
here ; and that was, the difficulty of procuring provisions for so 
large a population, as not only the camps were supplied from 
our stores with bread, meat, pulse, salt-fish, wine, oil, and other 
things, but nearly the whole of the inhabitants of the district, 
amounting even at this time to between 7000 and 8000 souls. 

The district of Lefchimo had at all times been dependent for 
several months in the, year on the supplies it received from the 
city ; and now that it had been completely cut off from it for 
many months, and when no communication was allowed with 
it, except under the laws of health, nor even between the several 
villages within it, the people had no opportunity of sending 
anywhere to purchase, or of bartering for such necessary pro- 
visions as they wanted. Besides, their own little stock of corn 
and other things was by this time almost exhausted. Indeed, 
had any unfortunate circumstances occurred to protract the 
period of their liberation, I apprehend there would have been 
serious difficulty in affording them the necessary supplies. As 
it was, if it had not been for the humane attentions and paternal 
care of his Excellency the Lord High Commissioner, in even 
anticipating the wants of this suffering people at a very great 
expense, they would have had the misery of famine added to 
the calamity of plague. I doubt whether the inhabitants of 
Corfu appreciated, as fully as they ought to have done, the 
favours conferred upon them by his fostering hand at the period 
of their distress ; but I am quite sure that, if it had not been 
for his exertions in their behalf, as the head of the British 
government, they would have suffered more seriously than they 



IN THE PLAGUE OF LEFCHIMO. 



219 



did, not only from the plague itself, but also from its dismal 
consequences. 

The time was now approaching, too, when the people wished 
to cultivate their vines, and prepare their fields for the ensuing 
crops. Permission, however, could not yet be granted them to 
work in their fields, without breaking down the barriers of 
quarantine; that is, without allowing intermixture among 
the people of the different villages, which it was not yet 
proper to do. For, if the system, which was being carried on with 
such marked advantages, had been interfered with, we could not 
have calculated on the consequences; and if plague had 
unfortunately broken out in any one place, there would have 
been no telling where it would end, had the people obtained the 
permission they sought for. As matters now stood, if it had 
broken out, it would have been confined to the inhabitants of 
that village alone where it appeared, and would not have ex- 
tended to the others, so that it would have been an easy matter 
to have stopped it there, though a most serious one to have had 
to begin the whole work over again. I was daily importuned to 
consent to this solicited permission, but I could not take it upon 
me to do so, as it was a thing to be done only by a proclamation 
of the government; and which I knew would take place as 
soon as the public health allowed it. The people in the 
villages might no doubt have been permitted to cultivate their 
own fields, but I could not have been certain, in this case, that 
they would not have strayed to the other villages; nor could I 
have spared the military from the other important services on 
which they were employed, merely to attend and look after such 
working parties, in order to prevent their straggling. The thing- 
was impossible. It was as much my duty also, had there even 
been a sufficient number of troops for this purpose, to take care 
that their health should not suffer from extraordinary fatigue 
and exposure to the heat, as it was to attend to that of the in- 
habitants of Lefchimo. In short, the people being at this time 
confined to their villages, the restraints of quarantine were to 



220 



PLAN OF MANAGEMENT 



be rigidly adhered to, without regard to favour or affection; and 
in pursuance of the system which was being earned on, no devia- 
tion whatever from quarantine law could be allowed, until by 
a little time we could remove all restraint with safety. 

Another important reason for sending the people home, and, 
indeed, for straining every nerve to bring matters to a speedy 
termination, was the approach of the hot season, as already 
noticed, from which we had so much to dread. This I foresaw, 
and reported to the government at my first inspection of the 
district; and most fortunate it was for every one concerned that 
we were all liberated before the autumnal fever had done 
much mischief. 

Preparatory to the liberation of the camps, another circum- 
stance required particular attention, which was the state of the 
houses they had left, many of which were entirely destroyed 
by the fire in the first instance, when the system of burning 
them had been resorted to ; and others were so much dilapidated, 
as to be no longer habitable, particularly in Marathea, Clomo, 
and Rummanades. The government was anxious to render the 
people comfortable, and, as far as possible, they were supplied 
with the means of making themselves so, and of rendering 
their houses secure for the present, which was all that could be 
done. 

On one occasion, I remember having sent the carpenters em- 
ployed about the camps to repair some of these houses, but I 
afterwards regretted having done so, as the General told me 
soon after, that in the plague of Malta, a carpenter employed 
in the same kind of duties cost the loss of several lives, and of 
forty days hard labour, to get the better of the mischief caused 
by his carrying the contagion to a place which had been cleared 
of it. I had taken, however, the precaution to send a guard 
with those carpenters, in order to prevent all intercourse betwixt 
them and the people. But still my sending persons from the 
camp district to a clear village was not quite correct, although 
no bad consequences followed. 

The first camp liberated was No. 1, simply suspected, whose 



IN THE PLAGUE OF LEFCHIMO. 



221 



period of quarantine had expired, whose health was free from all 
contagion of plague, and whose effects had been fully purified. 

It happened in some of the camp liberations, that several of 
the persons about to be sent home were so weak and indisposed 
from ordinary complaints, that they were unable to walk to their 
villages; nor could the roads admit of any carriages, if I had 
had such at my disposal for their accommodation. Their neigh- 
bours, who were returning home with them, would not assist in 
carrying them, as they were sufficiently loaded with their own 
effects, which having recommended the people to take along 
with them when they were ordered to camp, I was consequently 
bound to let them carry back, and to afford them every facility 
for doing so, consistent with the rules of quarantine; nor could 
I order the people from the villages to come and assist them to 
carry home their effects. 

In these cases, which, however, were fortunately but few, it 
was thought best to detain them for a short time where they 
were, till they should get better, or die ; for had they gone home 
to their villages, and died before the expiration of their 
quarantines of observation there of fifteen days, the circum- 
stance might have caused an unpleasant sensation, and led to 
an opinion that they had actually died of plague, and conse- 
quently would have retarded the general pratique ; and accord- 
ing to the laws of quarantine, it would have been necessary to 
bury them as plague bodies by the becca mortis. Everything 
possible in the way of rendering them comfortable, and of 
giving them medical attendance, was done ; and, in a few days 
afterwards, they were able to return. One poor woman, how- 
ever, who had been long ill, died in the camp. Indeed, no at- 
tention could have saved her ; and perhaps it was better on her 
own as well as the public account that she was not removed. 

Previous to the people quitting the camps, it became necessary 
for myself to examine minutely every individual, to ascertain 
their perfect state of health; after which, avoiding all contact 
or communication with any of the other camps, each party was 
marched off to their respective villages under an officer's guard; 



222 



PLAN OF MANAGEMENT 



and lodged within their own houses, where they performed a 
strict quarantine of observation of fifteen days, under the 
orders of the military commandants of the villages, during 
which time they were examined every morning by a medical 
officer, who made a regular report to me of all occurrences. 
Sometimes the military commandants were present at these in- 
spections, to give an appearance of more authority. All these 
inspections may by some be supposed to have been unnecessary; 
but it is known that persons returned from quarantine are more 
apt to conceal any indisposition than they were whilst actually 
under severe restraints, and more unwilling to submit to ex- 
amination. 

These inspections were occasionally made by myself after- 
wards in the villages, as I was extremely anxious at this trying 
period to see that all was right, and if any case of plague 
should unfortunately occur, to take the proper steps instantly, 
and again shut up for some time the village in which it shoidd 
appear. 

As the regular troops were not numerous enough to guard 
the people who had returned to their houses, in addition to 
their other duties, the primates and deputies of the villages 
were called upon to furnish a sufficient number of steady well- 
behaved men, to assist in this duty for the fifteen days of 
quarantine, which the people just returned had to perform. 
These were placed under the orders of the military and medical 
officers, and were not only to prevent any intercourse betwixt 
the newly returned and the rest of the inhabitants, who had 
never been removed from them, but also to have none with 
themselves, as all such would be a breach of the quarantine 
law, and would be punished accordingly. And as an inducement 
to these civic guards to behave with fidelity, they were allowed 
daily by the government the sum of twenty paras, about seven- 
pence sterling, while thus employed. 

The purport of subjecting the people returned to their 
homes to observation for fifteen days was to put the expurga- 
tion of their houses to decisive proof, and to meet the enemy, 



IN THE PLAGUE OF LEFCHIMO. 



223 



if he still existed. I had not the least doubt, when I made my 
reports of the state of the expurgation, that all was as perfect 
as in any case of the kind it could be. But it was still 
possible that something impested might have escaped the ex- 
purgators and myself; and if anything of the kind had remained 
undiscovered in these houses, or if any hoards in, or immedi- 
ately about them, had escaped our notice, it was reasonable to 
suppose that the persons who knew where they had concealed 
things (supposing everything not to have been discovered,) 
would naturally look after them the very first moment they 
could, and a return of plague might have followed. 

The people were therefore not strictly confined to their 
houses, although still prevented from mixing with other families ; 
and they were recommended to ventilate well their houses, and 
look about them as much as they pleased, so that if there really 
had been any undiscovered articles which contained the con- 
tagion, it might have shown itself before their period of quar- 
antine expired; and the sooner it made its appearance the 
better. 

General Return of the District of Lefchimo on the 
29th of April, 1816. 

Sick in the Lazaretto ... ... ... ... ... ... ... 30 

Convalescents from plague, exclusive of those employed as expurgators 42 

72 

No. 1. Camp, simply suspected, formed on the 26th February, and no 

admissions received into it .. ... ... ... ... 202 

No. 2. Camp, simply suspected. First division, formed on the 26th 

. February, and shut the 12th April 140 

Second division, formed on the 21st April, and shut on the 28th do. 87 

227 

No. 3. Camp, highly suspected. First division, formed on the 29th 

March, and shut on the 10th April ... ... ... ... 81 

Second division, formed on the 11th April, and shut on the 25th do. 67 
Third division, formed on the 26th April, and shut on the 27th do.... 15 

163 

British troops simply suspected, in observation apart from the natives 27 
Greek infantry, ditto ... ... ditto ... ... ... 8 

35 

Total 699 



224 



PLAN OF MANAGEMENT 



I can hardly find words to express the universal joy which 
was spread over the whole district of Lefchimo, particularly in 
the upper part, when the first camp liberation took place on the 
29th of April; I say particularly the upper part; for the in- 
habitants of this district were first liberated, as the expurgation 
of Lower Lefchimo was not yet completed; consequently, its in- 
habitants could not yet be sent home. The people seemed to 
feel a new life infused into them ; and from a state of sadness 
and despondency, they gave way to the most extravagant 
expressions of joy and exultation, which it were difficult to 
describe, and which are produced by feelings which only those 
can have an idea of who have been similarly situated. They 
did not, and perhaps even could not fully understand or appre- 
ciate the meaning of the system that was being carried on, or the 
advantages resulting from it ; and it must be allowed that people 
can seldom under any circumstances reconcile to their feelings 
the necessity or advantages of quarantine restraints. They now 
saw, however, what they could never be brought to believe be- 
fore, that we had no wish whatever to keep them in the camps 
longer than it was absolutely necessary; and that it was not 
from mere caprice or cruelty that we were acting, but that, from 
every consideration both to their individual good and the 
general safety of the community, we had been induced to use 
these seemingly harsh and unpalatable measures. I myself 
cannot well express my satisfaction on delivering the people 
over to the officers to be conducted to their homes.* 

On liberating this camp, it was fully explained to the other 
camps that they should all be sent home as fast as it was pos- 
sible, consistent with the public safety; and to those who were 
discharged, now and subsequently, I earnestly recommended, 

* The first liberation took place on the 29th April from No. 1 camp, simply 
suspected ; and the number then discharged amounted to 139. At the end of 
fifteen days, on the 15th May, they were allowed to communicate with the 
villagers, by proclamation from government. 

Those belonging to Lower Lefchimo could not be liberated, as I said, until 



IN THE PLAGUE OF LEFCHIMO. 



225 



that if they had anything concealed, they would not touch it 
themselves, but mention it to any of the officers, or to their 
magistrates, when, on their acquainting me with the circumstance, 
I would immediately send some expurgators to destroy it, and 
pay them its value. I also warned them against the danger of 
touching any rags or pieces of cloth which they might acci- 
dentally fall in with. Possibly, by this time, no plague con- 
tagion might remain in such, but, at all events, it was much safer 
to let them alone. 

One would have imagined that the sad havoc which the 
plague had made among the papas in Upper Lefchimo, at the 
beginning of the malady, would have deterred those in the 
Lower from violating the quarantine laws there ; but such was 
not the fact ; for those papas, from their bigotry, ignorance, and 
superstition, were in themselves the authors of serious mischief, 
and indirectly were the cause of the infringement of the laws, by 
their influence over the minds of the ignorant country people, 
until we brought the whole of them into the camp district, and 
placed them in strict surveillance there, where they could do no 
harm, and thus frustrated their mischievous practices for the 
future. I had frequent occasion in my official reports to notice 
the turbulent and refractory conduct, not only of the papas, but 
also of the people of the lower district generally. But the 
General was unwilling to adopt measures of severity, and 
eventually we succeeded in extirpating the plague without 
them. 

Whilst the expurgation was going on in Lower Lefchimo, 
some of the papas there made application to Mr. Tully for per- 
mission to hold a religious meeting on Easter Sunday, a day of 
great ceremony, according to the rites of the Greek church. 

their houses were expurgated and made ready for their reception ; and they 
consequently were not sent home till some days after. 

The integrity of the camp No. 1 never was interfered with. Not so that 
of No. 2, of the same class, where the admissions were received as they 
occurred, until I put a stop to them, opening another division of the same 
class, as I have already mentioned. 



226 



PLAN OF MANAGEMENT 



This Mr. Tully very properly refused, giving them his reasons 
for so doing, and with these they seemed at the time quite 
satisfied. 

At this period, the village of Melichia had been thirty-seven 
days free from plague, and, according to all reports, the inhabit- 
ants had enjoyed good health, and had been carefully expurgating 
their effects, and obeying the rules of quarantine ; so that, in fact, 
they were already considered free from plague, and would have 
got free pratique among themselves in a few days, when, on the 
thirty-seventh day from the last plague accident, the disease re- 
appeared. Mr. Tully, who was on the spot, lost no time in 
investigating the matter; when he found, to his great surprise, 
that three churches in that village had been clandestinely 
opened, on the night preceding Easter Sunday, by the papas, 
who had performed service in them to the inhabitants. This 
happened on the 20th of April, and on the 23rd the disease 
appeared, and was removed to the lazaretto ; while those to 
whom direct communication with the impested family was 
traced, and all those who were known to have been at the 
churches on the occasion mentioned, were sent, according to 
their different degrees of suspicion, to quarantine or observation 
in the camps; the whole, first and last, amounting to 92. 

Mr. Tully, in his report to me of the 26th April, on these 
matters says — " I am credibly informed that these papas, in 
open violation of the laws of quarantine, and in defiance of re- 
peated orders on the subject, and a refusal from me to their 
request, have celebrated mass on Easter Sunday at midnight."* 

We were greatly alarmed at the appearance of plague in 
Melichia at a time when we had so little reason to expect it, the 
more particularly when we knew the promiscuous meeting that 
had taken place ; but we were thoroughly convinced that it was 
owing to some second cause, some secret violation of the laws 

* After this, I determined to remove all the papas to the camps, and thus to 
prevent similar congregations of the people. 



IN THE PLAGUE OF LEFCHIMO. 



•227 



of health. The prompt measures, however, which were resorted 
to on the occasion effectually prevented the much dreaded 
mischief from extending. 

It was afterwards ascertained, through the medium of con- 
fession, that a man named Samueli, belonging to Potami, had 
evaded the sentinels, and thrown across the river some piastres 
wrapt up in a piece of linen, to a woman of the name of Canta, 
for the performance of some service which he required of her. 
This woman took up the money, wrapt up as it was in the 
cloth, and placed it in her bosom. She gave it afterwards to 
her daughter, Maria Canta, just as she had found it. A few 
days after this, the daughter was attacked with strong symptoms 
of plague, and was immediately sent to the hospital, where she 
soon died. The mother, who had handed her the money, and 
attended on her till her removal, escaped. 

Some cases of plague had lately before appeared in the 
village of Potami, and we knew, or at least suspected, that the 
enemy was still lurking there ; and means were taken to cut off 
Potami from the other villages ; but this was evaded by Samueli 
in the manner just described. 

Soon after this, the plague manifested itself in the family of 
Samueli, which consisted of five persons, every one of whom 
died. I have no doubt, therefore, that the plague was in his 
family, and actually in his own constitution, at the time he 
threw the money across the river, although the symptoms had 
not then manifested themselves. It was strongly suspected 
that the disease had been introduced into his family from 
robbing one of the impested houses, which had not yet been 
expurgated. Indeed, we had too great reason to believe that 
several desultory cases of plague, which occurred towards the 
end of the malady, were owing to this cause, although the fact 
could not be brought home to the guilty. In plague, it is 
sometimes even more difficult than on other occasions to obtain 
positive proofs, so as clearly to convict the offenders. 

The re-appearance, therefore, of the plague in the villages of 



228 



PLAN OF MANAGEMENT 



Potami and Melichia rendered it necessary to cut them off from 
the healthy villages ; and Captain Bocca Chiampi, the military 
commandant of Lower Lefchimo, was accordingly directed to 
take the proper steps for effectually doing so. 

I was apprehensive that these desultory cases of plague which 
occurred among the villages of the lower line would have pre- 
vented the return of the people belonging to these villages who re- 
mained in the camps; but when it was considered that these were 
only solitary cases, caused by individual irregularities, that they 
were promptly removed, as well as every one suspected of 
having had intercourse with them ; that plague was not preva- 
lent in the villages now shut up ; and that the cases which did 
occur were satisfactorily traced to those irregularities, there was 
less reason to dread mischief than if their sources had not been 
discovered. Moreover, it would have been a great hardship on 
the people in the camps to have had their period of quarantine 
protracted on account of the irregular and nefarious conduct of 
the people remaining in the villages ; thus punishing them for 
the misconduct of their wicked neighbours, which was not to be 
done if it could be possibly avoided. It was therefore decided 
by the Major- General, and the result proved that he was right, 
that these solitary cases of plague should not prevent the return 
of the people to their villages, or protract the great object we 
had in view, that of bringing everything to as speedy a con- 
clusion as possible, as their houses were now expurgated, and 
ready for their reception ; and there was the less danger to be 
apprehended from carrying this measure into effect, as they had 
still to perform a quarantine of fifteen days after their return, 
during which they could run no risk from any plague remaining 
in the villages: and if even during the term mentioned, or 
subsequent to it, some cases of plague should occur, the same 
plan of management now in force, which was to be continued 
as long as necessary, would have checked immediately any 
mischief Avhich might start up. 

By thus sending home the people to occupy their houses in 



IN THE PLAGUE OF LEFCHIMO. 



229 



the villages, though solitary cases of plague did occur there 
afterwards, an immense step was gained towards free pratique ; 
whereas, if that had not been done, and had they not been re- 
turned until forty days from the last case of plague, according 
to the old mode of acting, there was no saying how long these 
poor people would have been confined in the camps, or to what 
period the operations would have been protracted. 

It is necessary here to mention that previous to the people 
having been sent from the camps, those inhabitants who had 
been shut up in the villages were liberated and allowed free 
pratique among themselves ; and it was the intention, after the 
expiration of the fifteen days of quarantine w^hich the people 
had to perform after their return to their homes as a proof of 
the expurgation of their houses, that they also should be 
liberated, and allowed free pratique with the rest of their towns- 
men within their respective villages, but not to mix with the others, 
(should no appearance of plague occur to prevent their doing 
so ;) and it was a happy circumstance that, during the w 7 hole 
period, the trials of the health of the people on their return to 
their homes were going on, no case of plague ever occurred to 
prevent the proposed measure, or to throw any doubt on 
the expurgation being completely perfect in destroying all 
contagion. 

It is seen that the first camp liberation took place of the 
class of simply suspected, after they had completed their full 
quarantine of forty days. 

The highly suspected class, or camp, from its very nature, bears 
a worse character than the simply suspected one ; because it is 
here supposed, much more than among the other class, that the 
plague exists ; consequently there is more to dread of the 
plague starting up here, and it is usual on this account to order 
the full quarantine of forty days. I believe it never has been 
considered prudent to release any of that class until after the 
expiration of that time ; and on some occasions many have had 
to perform what is termed forty days oi foul quarantine, and also 

R 



'230 



PLAN OF MANAGEMENT 



forty days of clean quarantine, making in all not less than eighty 
days, a prolonged confinement exceedingly appalling to those 
whom it is necessary to place under restraint, and which I 
conceive can never be required for the protection of the public 
health, if proper measures are adopted. 

In our peculiar situation it was necessary that as little time 
as possible, consistent with the permanent security of the island, 
should be lost in sending the people of this camp, still re- 
maining, home ; and I find on reference to the dates, that the 
liberation of the first division of this camp took place on the 
1 1th of May, just twenty-five days from the last accident of plague 
which occurred in it, and which was on the 17th of April. This 
was an experiment which, from necessity, in our own peculiar 
situation, we were obliged to make ; but which, according to the 
old system, could not have been authorized. Be it remembered, 
however, that we were all at our posts, and knew what to do in 
case of failure. 

I find on examining the returns of the highly suspected camp, 
that all the divisions and sub-divisions had been liberated and sent 
home to their respective villages after a period of twenty-five days 
from the last case of plague which occurred in them, or the date 
of their being shut up, and this, as was afterwards proved, with 
perfect safety ; thus showing, as far as the case goes, that 
there is no necessity for the lengthened quarantine of eighty, 
or even of forty days in any case, if purification is properly at- 
tended to. 

Under the same management, the persons simply suspected, 
who were sent to the camps, were afterwards released at the 
end of sixteen or seventeen days, thus reducing the usual period 
of forty days to less than one half of the time, and with safety. 

It is not necessary to detail the different periods at which 
these camp liberations were made. Suffice it to say, that after 
performing a quarantine of observation for fifteen or seventeen 
days, they were sent back to their villages, where they again 
performed a further quarantine of fifteen days for the proof 



IN THE PLAGUE OF LEFCHIMO. 



231 



of their houses, at the end of which they were allowed to mix 
freely with their neighbours. 

It happened in the plague of Lefchimo that several persons 
supposed to have plague were sent to the hospital, who soon 
afterwards got well, and continued for a length of time in ap- 
parent health, so that it was uncertain at the time whether the 
complaints for which they were admitted were really or not very 
slight cases of plague, until afterwards, some of them were 
attacked by the malady with violent symptoms. 

These are distressing cases, but such will happen in the time 
of plague, and cannot well be always prevented, notwithstanding 
all our care. 

With regard to such cases, my opinion is, that in the first 
instance the complaints were not plague, but that the patients 
contracted the disease in the hospital. It might, however, have 
been otherwise. 

It will be found, too, that sometimes persons in a distressed 
state of mind, seeing their nearest and dearest friends and rela- 
tives carried away to a pest hospital, and actuated by the 
strongest natural affection, which makes them unwilling to be 
separated, pretend that they themselves are very ill, in order 
that they maybe allowed to accompany the dear objects of their 
regard. Of this I have already given an example. These 
cases, when they occur, are to be deplored ; and it is to be 
regretted that any affectionate feelings, though otherwise so 
much to be cherished, should ever induce persons to put them- 
selves, without necessity, in such imminent danger, where, some- 
times at least, all the attention they are able to bestow can be 
but of little service to the patient himself. For my own part, I 
am so convinced of the additional danger they thereby expose 
themselves to, that I would pause and examine well into the 
matter before I allowed such feelings to be regarded. 

When, however, it happens that cases supposed to be plague 
are admitted, and which, after a time, turn out not to be such, 
they ought to be removed from the pest hospital as soon as 

r 2 



232 



PLAN OF MANAGEMENT 



possible. They should then undergo the complete spoglio ; and 
be well washed. This is all that can be done to preserve them ; 
and if they are not already contaminated, we have every reason 
to hope, if at the end of fifteen days they are free from plague 
symptoms, that they will eventually be saved ; whilst, on the other 
hand, should they be permitted to remain in the hospital, every 
day adds to their danger; for there is no fact better established 
in medicine than that the body will not receive infection at one 
time, but will readily do so at another. 

As soon as I saw that the plague was attacking some of these 
persons, whom it would appear had been admitted into the hos- 
pitals as cases of positive plague before my arrival, and who, 
having soon got well, were borne on the hospital return as con- 
valescents, I began to be alarmed, for I knew the almost uni- 
versally received opinion that those w T ho have once passed 
through the disease are in little danger from a second attack in 
the same season ; I suspected what these cases were. I imme- 
diately dismissed all those from the hospital barriers who ap- 
peared to be well, and placed them in quarantine near it, under 
the eye of the guards. Had I been aware ofthese cases, I should 
not have allowed them to remain one hour within the barriers or 
to mix with the patients or convalescents ; but I never suspected 
the matter until it was reported to me that some of the conva- 
lescents had been attacked a second time, and were very ill. 
Of course, the sick were attended, and remained in the hospital, 
and the quarantine of the others commenced from the day they 
left it, until they were finally liberated. 

It is probable that cases of this description have led to the 
opinion that patients have been attacked with plague twice dur- 
ing the same season, when, in point of fact, they were only 
attacked once ; and hence the conclusions have been drawn that 
when they died, they died of a second attack, and when they 
recovered, that second attacks are seldom fatal. 

It will be found to be extremely inconvenient, if not altogether 
impossible to dismiss, for the performance of quarantine, the 



IN THE PLAGUE OF LEFCHIMO. 



233 



convalescents from plague as each respectively has passed 
through the disease, in the same manner as we are accustomed 
to discharge convalescents from an hospital in cases of fever, or 
other complaints ; for every such convalescent from plague re- 
quires the same management, and the same scrupulous attention 
to well guarding, as if the number of such was consider- 
able. It were difficult to accomplish this, even if we had a 
separate apartment, or tent, to place each individual in, for the 
keeping the account of so many different quarantines would be 
liable to confusion, independent of the trouble of doing so ; and 
in an encampment, as I have stated, it would be almost impos- 
sible, since it would increase the military duties beyond all 
reasonable bounds, to say nothing of the extraordinary ex- 
penses which would be incurred from placing each individual 
in a clean tent by himself. Besides, strictly speaking, no one 
can be considered as convalescent from plague until all his sores 
are healed, which often requires a long time after the immediate 
danger is over, and indeed, after he has safely passed through 
the disease ; for until these are perfectly healed, and even for 
some time after, they are found to be as liable to communicate 
the disease to healthy persons, as they were during the violence 
of the symptoms. It is, no doubt, unpleasant for individuals to 
be prevented from entering on their foul quarantine as soon as 
they can fairly be considered convalescents and in health, except 
as regards their sores ; and I do not mean that in every case this 
is to be done, because it may be necessary at times to deviate 
from this regulation ; but I mean to say that their being detained 
for some time after will most probably not add to their danger, 
however unpleasant and inconvenient it may be to them. It 
will be better, therefore, to defer encamping them, or even 
placing them in houses, until there is a number of them collected 
together, when the same management will be sufficient for all. 

In my inspections of these convalescents, I remarked that the 
buboes seemed to have healed more kindly than we generally 
see in some cases proceeding from venereal complaints; for of the 



234 PLAN OF MANAGEMENT 

whole, only one remained fistulous, and this was that of a care- 
less fellow, who would not keep himself quiet, or attend to the 
directions given him. I remarked also that the site of the pes- 
tilential bubo in the groin was as nearly as possible that of the 
venereal bubo. I mention this, because it has been generally 
believed that the situation of the pestilential bubo is sometimes 
lower than the other. 

Previous to placing the convalescents, and the cases of sup- 
posed plague, on their foul quarantine, it became necessary to 
prepare a place where they could be properly secured. For 
this purpose, a strong palisading was erected, having three 
sides of a square, with an open front towards the sea. These 
w r ere divided by a partition, or what may be termed a street, 
within which the sentinels were posted to prevent all intercourse 
between the two classes into which the whole were divided; one 
of which consisted of the few cases of supposed plague, as I was 
unwilling to expose them to additional danger, by placing them 
in the same divisions with the convalescents from plague. The 
second division consisted of those who had passed through the 
disease, and were perfectly cured. The period of quarantine 
was the same for all ; although I give it as an opinion that the 
one of the supj^osed, or doubtful, cases might perhaps have been 
diminished. The whole who were encamped on this occasion, 
exclusive of the convalescent expurgators, amounted to 59. 

Before the people entered this encampment, they were all 
carefully examined by myself, to see that they had no running- 
sores ; and those whose sores were not perfectly healed were 
kept back till the final encampment of the whole, masters, ser- 
vants, condannati, &c, took place, when the hospital finally was 
broken up. 

After this examination, and when the people had been well 
washed with soap and water, each individual received an entire 
suit of clothes, which had been sent down from the city for them, 
and at the end of 40 days from the date of their being encamped, 
they were furnished with another suit, more as an act of gene- 



IN THE PLAGUE OF LEFCHIMO. 



235 



rosity from Government, than of necessity. Their own clothes 
were collected together by the condannati, and burnt, care being 
taken that on entering the encampment, every article capable 
of containing the contagion was taken from them and immedi- 
ately destroyed. Such of them as had gold or silver coins, or 
ornaments of precious metal, received these back after they 
had been passed through hot vinegar and water ; and in order 
to prevent anything from being stolen or mislaid, the owners 
themselves stood by to receive them ; after which, they were 
marched off to their tents. 

As I was apprehensive lest some of them might have secreted 
things about the hospital, I particularly explained to them the 
necessity of producing every article so concealed, in order to 
have it purified, when it should be restored to them; warning 
them, at the same time, that if they did not follow my injunctions, 
such things, when found out, would become the property of the 
expurgators, when the hospital was expurgated, as was done in 
the plague of Malta. 

I observed also at these inspections that several of the people 
wore charms tied about their necks, to which they imputed their 
recovery from plague. These were kept in little bags, some of 
which they were very unwilling to part with. In some of them 
were little bits of bones, or other hard substances — relics, no 
doubt; and in others, old coins or holy medals. These charms, 
or amulets, on which they seemed to set a great value, were of 
course restored to them, after they had been properly cleaned. 



236 



PLAN OF MANAGEMENT 



CHAPTER VI. 

The people returned from the camps unwilling to occupy their houses — Not 
fewer than three persons supposed sufficient to prove an impested house — 
Considerable anxiety whilst such proofs were going on — The people now 
remaining in the camps permitted to draw supplies from their villages — 
The corps of expurgators diminished — Directions to the medical officers 
whenever sickness should occur in the district— The people permitted to 
pull their flax, but not to steep it for the present — A discovery of concealed 
goods made by accident — An alarm of plague in Marathea — Craftiness and 
ingratitude of certain inhabitants of Lefchimo. 

I have already stated that the people in the camps, whose 
period of quarantine had expired, had been sent home to their 
villages to perform a quarantine of fifteen days in their houses, 
as a proof of the expurgation being perfect, and also of their 
own health. I find it, however, necessary to return to that 
part of the subject, and to mention some difficulties which 
occurred in carrying this measure into effect. 

Many of the people, partly from fear and partly from other 
considerations, were extremely unwilling to submit to this 
order ; and some of them, particularly in Perivoli, positively 
refused to obey it, alleging that they would rather wish me to 
give orders to destroy their houses at once than subject them 
to a quarantine of fifteen days in such comfortless and dilapi- 
dated habitations, as also to the danger they apprehended from 
again being impested by occupying them. Indeed, I have no 
doubt that some would have been glad if I had ordered their 
houses to be burned, as they thought they would then have a 
claim upon government for indemnification. This, however, 
was not the only consideration, although it would have been of 
itself a very serious matter, which no government could be ex- 
pected to grant. But there was another question involved in 
this, which was the ascertaining by proof whether plague con- 
tagion remained in the houses, and whether the island was per- 



IN THE PLAGUE OF LEFCHIMO. 



237 



manently secured, both of which would be affirmed, if no 
plague broke out among them afterwards. It was therefore 
determined that no plea should be admitted, or any pretence 
allowed, for not occupying on their return their former abodes, 
as free pratique among the villages would not be granted until 
the period mentioned of fifteen days further quarantine was 
safely passed. 

It sometimes happened that the families just returned had 
(let us suppose) three separate houses, all of which had been 
treated as impested, and consequently were to be occupied. 
In this case, if the family consisted of nine persons, three were 
sent to each house ; for supposing that the seeds of plague 
remained in them, and that only one, or even two persons 
occupied a house, it might happen that the one or two inmates 
were unsusceptible of plague, but if three occupied it, the pro- 
bability was that some of these (all being supposed to have 
free intercourse with one another) would contract the disease, 
and show that plague still existed in them; whilst, if they all 
escaped, it was the strongest presumptive proof that all was 
right, and the most satisfactory experiment that could well be 
made, at the same time that the enemy, if he still was lurking 
anywhere, was turned out, and met upon our own ground. 
Indeed, we had no other mode of arriving at the certainty we 
wished, and which it was necessary to obtain. Three persons 
are the least number that ought to be taken in a case of this 
kind. 

It also happened that some of the families had been so 
destroyed by the plague as to have but one solitary individual 
left belonging to each of them. In such cases, either the pro- 
prietor himself or the magistrates were directed to procure for 
hire persons to perform this proof, the expense and maintenance 
of whom were defrayed by the proprietor ; nor latterly did we 
experience any difficulty in finding such people among those 
who had returned from the camps. On a few occasions, the 
proprietors refused to defray the stipulated recompence after 



238 



PLAN OF MANAGEMENT 



the period had expired, when I was obliged to interfere, and 
cause payment to be made, or security to be given. 

The expense of purifying the public buildings, such as the 
churches, was defrayed by the community, and proper persons 
to prove them were hired by the magistrates for that purpose. 

We had so much trouble at first in settling these matters, 
that, in order to prevent any future discussions on the subject, 
it was determined to arrange the distribution of the people 
before they left the camps. Thus, if a village contained three 
impested houses, and if there were nine persons returning to it, 
three were sent to each house, no matter whether the house 
belonged to themselves or not. This, of course, produced dis- 
satisfaction among some ; but the feelings and caprices of 
people are not always to be attended to, and it was important 
that free pratique should not be delayed on this account. It 
was, perhaps, not a matter of very great consequence whether 
some of the houses were occupied or not, as I am perfectly 
satisfied that everything was well expurgated, consequently I 
did not conceive that there was any real danger. Yet it was 
necessary to conform to the rule laid down, and to make every- 
thing quite clear. 

It may naturally be supposed that, whilst these trials of health 
were going on, — the result of which was either to cut short 
our wearisome labours or to extend them perhaps to a con- 
siderable length of time, should we happen to be involved 
again in plague, — every one felt extremely anxious till the 
probationary period was over. Indeed, I can hardly express 
our feelings of satisfaction when, at the expiration of this ordeal, 
I found, on my final examination, that nothing like plague 
showed itself among the people. 

Some of those still remaining in the camps having expressed 
a wish to be allowed to receive some provisions — such as oil, 
wine, vegetables, &c. — from their friends in the villages, which 
by this time were in perfect health and in free pratique amongst 
themselves, the request was immediately granted, taking care, 



IN THE PLAGUE OF LEFCHIMO. 



239 



however, that nothing of a susceptible nature was attached to 
the articles sent, not even a piece of string, and those of each 
village bringing their supplies at a different time, in small 
parties, generally twice a week. These provisions were then 
deposited at a certain place, under the inspection of a military 
officer, who was responsible that nothing susceptible was 
attached to the things, and that no intercourse took place be- 
tween the people and the camps. The persons for whom they 
were intended were then called to fetch them, and were allowed 
to hold as much conversation with their friends as they pleased, 
but not to come in contact with each other. The people also 
wished to receive a supply of clothes ; but this, for obvious 
reasons, could not at the time be permitted. 

About the 6th of May, it was reported to me that a case of 
plague had appeared among some shepherds, who were tending 
their flocks in an insulated place in Lower Lefchimo, which 
was supposed to have originated from some of them having 
been concerned in robberies that were going on, or from their 
having fallen on some impested effects. For fear lest anything 
serious should spring out of this circumstance, their state of 
health was immediately examined by Mr. Tully, and they were 
afterwards sent to a distant part, under a military escort, to 
watch and prevent their having any intercourse with other per- 
sons. They were again frequently examined, and after a period 
of ten or fifteen days, and being found free of plague, the 
guard was withdrawn from them ; they were permitted to leave 
their present abode, and to feed their flocks as usual, but were 
directed not to enter any of the villages. Lest there might 
have been any concealed effects in their huts and haunts, these 
were examined by the expurgators. 

In this instance, the shepherds were not sent to the camps, 
as usual, on account of their flocks, which would otherwise have 
been lost or destroyed, to the serious detriment of the pro- 
prietors. 

By the 25th of May, the expurgation of Lower Lefchimo 



240 



PLAN OF MANAGEMENT 



was completed, and all the impested things either destroyed or 
sent to the depot, or purifying-house, already mentioned as 
having been burnt by the orders of government. By this time, 
too, all the people of Upper Lefchimo had returned home, and 
the inhabitants of the villages were permitted, by proclamation 
from government, to mix freely with one another. 

It being, therefore, no longer necessary to keep up so great 
a number of expurgators, amounting at the time to nearly fifty, 
on full pay at a very serious expense, it was determined to 
diminish this force by discharging the convalescents from 
plague for two reasons — first, in order to save expense ; and 
secondly, to place them on the performance of their foul qua- 
rantine, which determination could at this time be easily realized, 
as the state of the public health all over the district was favour- 
able, and we had a sufficient number of others (those which 
had been sent from Malta) left to finish what still remained to 
be done, and to manage any plague cases, should such unfor- 
tunately break out. 

The convalescent expurgators, amounting to twenty, were 
therefore discharged, and encamped under the same course of 
examination and management as that already mentioned, so 
that the whole of the convalescents and expurgators now en- 
camped amounted to seventy-nine. 

I may here give a statement of Lefchimo on the 1st of June, 
after all these people were encamped, and before the pest-hos- 
pital was broken up, on the 23rd of June, when the whole were 
placed in camp for the performance of their quarantine. 

General State of the District of Lefchimo, June 1st, 1816. 

Camp of simply suspected (a sickly creature, unable \ j 
to ba removed, and who died soon after) . . j 

Camp of highly suspected 2 

Under cure in the hospital 8 

Convalescents from plague 59 

Ditto who had been expurgators 20 

Total . . 90 



IN THE PLAGUE OF LEFCHIMO. 



241 



On the 8th of June, all those under cure in the hospital were 
pronounced convalescent, struck off the hospital return, and 
added to the convalescents, making in all eighty- seven, including 
the few doubtful or supposed cases of plague. 

In anticipation of the approaching hot season, and the 
fevers we expected in consequence, I had given instructions 
to the different medical officers to be on their guard against 
such appearances as the plague usually assumes, and when- 
ever anything of a suspicious nature occurred, to place the house 
in which it appeared in quarantine till such time as the matter 
was satisfactorily cleared up. They were also supplied with 
medicines proper for the complaints of those who might fall 
sick. 

As it was of the utmost importance that every case of sickness 
should be immediately ascertained and inquired into, most 
particularly where symptoms of fever showed themselves, I 
directed all the medical officers of the district to lose no time 
in apprizing me of whatever indisposition occurred either 
among the natives or the military, that I might see them before 
any steps were taken in the matter, or false alarms spread 
abroad, which, whether well or ill founded, would not only affect 
the character of the district itself, but also that of the whole of 
the island. 

■ With the view, also, of diminishing the duties of the military 
and the guardians, who were much exposed to fatigue and the 
hot weather in bringing me the daily reports, I directed that, 
unless there was anything particular, the daily reports from the 
villages should henceforth be suspended; and to make the 
duties as light as possible to every one, I used frequently my- 
self to ride to the villages, to learn what was going on there, 
and, from time to time, to examine such cases of sickness 
as occurred. In places where permanent sentinels were 
posted, temporary barraccas were erected to screen the men 
from the sun. Happily, however, although many cases of 
autumnal or remittent fever occurred in various parts of the 



242 PLAN OF MANAGEMENT 

district, yet no plague ever made its appearance to interrupt the 
arrangements which were going on, or to protract our stay on 
this distressing and anxious duty. 

I have stated before, that the people had been in free pratique 
within their respective villages, but as yet they were not per- 
mitted to communicate with the others. The time now arrived 
when it became necessary for the inhabitants to pull their flax; 
and they made application for permission to do so. This was, 
of course, immediately accorded, care being taken that the 
inhabitants of each village pulled the flax at separate hours ; 
otherwise, all restriction would have ceased, and the system we 
were going upon would have been infringed, which could not have 
been permitted ; for if that had been done, most probably some 
of them would have been shot by the sentinels, who were 
posted to prevent communication between the villages ; and it 
was fully explained to them that this permission to pull their 
flax was granted them on the express condition that they should 
not attempt to exceed their proper bounds, otherwise the in- 
dulgence would be immediately withdrawn, until free pratique 
was given to the whole of the upper part of the district. 

But though permission was granted them in this instance, it 
could not be extended to them on all the occasions on which 
they required it; for if so, all idea of quarantine restraint 
would have been done away with, or, at least, would have been 
merely nominal, and, as T have already remarked, it would have 
been quite impossible to have employed the military to watch 
over so many scattered parties. 

A fresh application was soon afterwards made for leave 
to steep their flax in rivulets and stagnant pools near their 
villages ; but this I positively refused for the present, conceiving 
that it might be productive of sickness, which, under existing 
circumstances, would have caused great uneasiness, and was 
therefore to be particularly avoided. 

Thus, at the time that it was necessary to look after the public 
health, the request for every proper indulgence consistent with 



IN THE PLAGUE OF LEFCHIMO. 



243 



that important object was readily acceded to ; and in diminish- 
ing the misfortunes of the people as much as possible, we en- 
deavoured to remove from their minds every unfavourable im- 
pression of unnecessary severity on our part towards them. 

I have already stated, that all the persons, on leaving the 
camps, were questioned as to their having any concealed effects, 
and that a reward was given to those who made any discoveries ; 
but where no confessions were made, I was naturally led to 
suppose that nothing was hid. However, some time after the 
issue of free pratique within the villages, Mr. Tully reported to 
me that a man named Colluri, belonging to Sant. Theodoro, 
who had lately returned from the camps, had, under cover of 
the night, gone to a place near his house, where he had secreted 
some cottons before he had been sent off to quarantine. The 
probability is that he wished to ascertain in what state the 
cotton was; and finding it much damaged, wished to burn it and 
conceal the matter. The cotton being wet, would not burn, 
but sent forth a cloud of smoke, which led to the discovery of 
what he was doing. As soon as the affair was known, one of 
the expurgators was sent to complete the destruction of the 
cotton. 

This provoking circumstance gave me a good deal of uneasi- 
ness, and led me to suspect that, as this had been discovered by 
mere accident, there might be other hoards of concealed things, 
the rooting out of which became now our principal concern ; 
and our anxiety in this respect was almost as great as if the 
plague had been raging at the time. This audacious and wicked 
fellow whilst in camp must have seen me day by day going 
round and entreating the people, with money in my hand to 
pay all who confessed to whatever they themselves had con- 
cealed, or knew to be so by others. Yet he, as well as all the 
rest, declared most solemnly that they neither had concealed 
anything themselves nor knew of others who had done so. This 
man deserved to have been punished in the most exemplary 
manner, but General Phillips was averse to severe measures ; 



244 PLAN OF MANAGEMENT 

the only punishment, therefore, inflicted on him and his family 
was sending them to camp, and keeping them prisoners there, 
until all quarantine restraints were finally removed from the 
district. 

Whilst things were going on thus favourably, a circumstance 
occurred which eventually, although productive of no bad con- 
sequences, caused, nevertheless, considerable alarm at the time. 

At the inspection of the inhabitants of Marathea, on the 
3rd of June, Mr. Muir, assistant staff- surgeon, discovered in a 
boy about ten years old, belonging to that village, and who was 
at the time indisposed, a swelling in his groin, of which he 
complained a good deal. This, at another time, would have 
been considered of no consequence ; but at this moment, and 
on such suspicious ground as Marathea, it was a very unplea- 
sant occurrence ; for if it had turned out to be a case of positive 
plague, it would have probably retarded the general pratique, 
and thrown a certain degree of suspicion over the whole dis- 
trict, notwithstanding that everything hitherto had gone on 
most favourably. Had the boy died, even though I might my- 
self have been convinced that the case was not plague, I am 
afraid that, according to the laws of quarantine, it must have 
been considered as such, and consequently been productive of 
much vexation to all concerned in this service. 

Every human precaution had been taken, and with the most 
scrupulous anxiety by all concerned, and the contagion, in 
every shape and form, considered to have been eradicated with 
as much positive certainty as anything of the kind had ever 
been, or could well be, in every part of the district ; for what 
still remained was supposed to be entirely confined within the 
camp district ; and from this there was nothing to fear, as it 
had always been well looked after and guarded by Captain 
Zerbi, of the Corsican regiment, who was nominated the mili- 
tary commandant there. A case of plague occurring now was 
therefore not at all calculated upon ; and if such had really 
happened, all our calculations, on the present as well as future 



IN THE PLAGUE OF LEFCHIMO. '245 

security of the public health, would have been at least doubtful 
and uncertain, in showing that all contagion had not been per- 
fectly destroyed ; for if but one solitary case of plague had 
occurred, the origin of which was not thoroughly ascertained to 
have been perfectly unconnected with the expurgation, there 
was no knowing how many cases might occur afterwards, nor 
where the mischief would terminate. 

Immediately on the occurrence being reported to me, on the 
5th June (two days after,) — for at first Mr. Muir did not think it 
necessary to mention the case, considering it a thing of no conse- 
quence, from the absence of other marked symptoms of plague, 
although he immediately took the precaution of separating the 
boy himself, as well as those in communication with him, from 
the rest of the villagers, — I rode off to examine this boy myself, 
and to inquire into all the circumstances of his case. I found 
him with a slight degree of fever and headach ; his tongue was 
not clean, but it did not exhibit that peculiar glossy appearance 
which I had observed in plague ; nor had he that anxious look, 
nor the staggering, so expressive of that disease. On examining 
the groin, I found a rather diffused enlargement of the inguinal 
glands, which he said was painful on being pressed ; and on 
looking at his leg and foot, I observed, what indeed Mr. Muir 
had already mentioned to me, that there was a sore on the boy's 
foot on the same side, to which Mr. Muir attributed the swelling 
in the groin, from the irritation and absorption of matter, and 
which had been caused by the prick of a thorn some time 
before. This, and the absence of the other characteristic 
plague symptoms, added to the perfect health of the other 
inhabitants, convinced me that the case was not one of plague, 
and that the swelling in the groin, as well as the indisposition, 
were only attributable to the cause I have mentioned. 

Although I was of opinion that the case was not plague, yet, 
as towards the decline of the malady it has been supposed that 
cases of real plague are sometimes remarkably slight, I deter- 
mined to send him to the camp, placing him by himself in a 

s 



246 PLAN OF MANAGEMENT 

clean tent, apart from every one else ; doing everything in my 
power to render him comfortable, and amuse the poor little 
fellow during the confinement, which I trusted would be only 
for a short time. It was necessary to place him in this sort of 
restraint, in order not only to watch over the progress and see 
the termination of his disorder, whatever it might be, as I was 
extremely anxious about him, but, as he required medical treat- 
ment, he could be much better looked to in the camp than it 
was possible for him to be in Marathea, where there was no 
medical officer stationed. 

He remained in the camp nine days, and was afterwards sent 
home to his friends, with the sore in his foot quite healed, the 
swelling in his groin almost entirely discussed, and without his 
having had any symptoms which could lead us to conclude that 
his indisposition, and the swelling in his groin, proceeded from 
plague. 

About this time, a circumstance occurred in the district, which, 
as arising out of the consequences of the plague, and in some 
degree showing the craftiness and ingratitude of the inhabitants 
of Lefchimo, it may not be improper to mention here. 

The primates and deputies of the villages having represented 
to me that they thought they would be able to raise a crop of 
corn after the issue of free pratique in the district, (which was 
contemplated to take place on the 15th or 17th of June, if 
nothing occurred to prevent it,) should the government only be 
pleased to afford them the means of doing so, by granting cattle 
to plough their fields, their own bullocks having been slaugh- 
tered early in the calamity, in order to supply the troops with 
meat, and the few horses they had being unaccustomed to 
plough, I consequently felt it my duty to call the attention of 
the government to this circumstance, and to state to the Major- 
General, in the strongest manner, that it would be good 
policy, as well as humanity and kindness, to comply with this 
request ; for, should they be thus enabled to raise a crop of 
corn in the season, this would prevent their being entirely 



IN THE PLAGUE OF LEFCHIMO. 



•247 



dependent on the city for a supply of grain, which would other- 
wise be the case, and the maintenance of upwards of 7000 
souls, depending for the greatest part of their necessary supplies 
from that source, was a matter for very serious consideration. 

I soon after received a letter from the Major- General, (who, 
if I mistake not, was at that time, in the absence of Sir Thomas 
Maitland, performing the functions of the Lord High Com- 
missioner, in addition to his other duties,) to say that my pro- 
posal would be acceded to as soon as possible. I communicated 
this information to the magistrates, who expressed their thank- 
fulness and gratitude on the occasion. 

Shortly after this, the bullocks arrived in Lefchimo, having 
been procured by the army contractors. As I was unwilling 
that there should be anything like partiality shown in the dis- 
tribution of them, I ordered them to be properly paired, and 
drawn for by lot among those who had requested them. To my 
utmost surprise, though some individuals received them with 
proper feelings of gratitude to the government, which had thus, 
from the kindest consideration of their welfare and future bene- 
fit, condescended to supply this necessary means of cultivating 
their fields, I found that by far the greater part declined taking 
them, alleging that they were too dear, with other frivolous and 
affected excuses. I suspected that there was some intrigue on 
foot, and something at the bottom of all this, and determined 
to sift the business thoroughly, when I soon discovered that the 
real motive for their refusing to take the bullocks, which but a 
short time before they had expressed such eagerness to obtain, 
as the greatest favour that could be conferred upon them, was, 
that knowing the cattle had now arrived within the district, and 
could not, consistently with the laws of quarantine, be sent back 
to the city, they therefore thought they would get them for 
whatever price they chose to put upon them. As to their 
alleged high price, that was merely an evasion, for the Com- 
missary-General would have gladly taken them at the same 
valuation, as rations for the troops ; and several of the inhabitants 

s 2 



248 



PLAN OF MANAGEMENT 



of the city offered to purchase them at the contract price. I 
confess I was forcibly struck with this instance of that people's 
low cunning and ingratitude, and could scarcely help regretting 
my having at all interfered in the business. They were, how- 
ever, afterwards obliged to take the bullocks at the stipulated 
price paid for them by the government, as I had sent up the 
names of the persons to Corfu ; and to give, on their receiving 
them, securities for payment, which were afterwards transmitted 
to the proper authorities. 



CHAPTER VII. 

On congregations of people in the time of plague — Certificate of the health of 
Lefchimo — Free pratique proclaimed within the district itself, but not 
between it and the rest of the island — Dissensions respecting property 
among the people of Lefchimo — The pest hospital broken up — The troops 
at the principal cordon very sickly from the remittent fever — Another 
alarm of plague in the village of Cuspades — The first fortnight of a general 
pratique always a critical period — Short account of the autumnal fever in 
Lefchimo — A case of sudden death from apoplexy — Necessity of with- 
drawing the troops from the villages, on account of the sickness among 
them. 

The villages having been for some time in free pratique with 
one another, the people became so extremely clamorous to have 
divine service performed in their churches, that I thought it my 
duty to report the circumstance to government. It was not, 
however, deemed fit to grant this permission, notwithstanding 
that those places had been expurgated and proved, as the tomb- 
stones had not yet been sent down to secure the plague graves, 
which were in some of them ; and it was considered improper 
to grant the permission in favour of any particular one, until 
the whole of them were ready. Moreover, it was perhaps as 
well to avoid general congregations of the people for the 
present. 

Mr. Clark, in his " Travels in Russia," vol. i., page 77, gives 



IN THE PLAGUE OF LEFCHIMO. 



249 



a remarkable instance of the bad effects of congregations of 
people in the time of plague. He says, that " during the plague 
which raged in Moscow, about thirty years ago, a picture was 
placed in one of the streets of the city, to which the people 
eagerly thronged upon the earliest intelligence of it. The 
Archbishop Ambrose, finding that the danger of spreading the 
infection increased as the people crowded to this picture, 
ordered it to be removed and shut up in a church, the doors of 
which were forced open by the populace, and the venerable 
prelate, being dragged from the convent of Donski, was in- 
humanly put to death." 

The people, in this instance, superstitiously believed that the 
saint whom the picture represented would be induced, by their 
prayers and invocations, to work a miracle in their favour, by 
relieving them from the calamity. For they were not fully 
aware, and would not be convinced of the danger attending 
these congregations, until they were brought to a state of sub- 
ordination by the interference of the military, which put an end 
to these tumultuous proceedings. 

It will be remembered, that the last case of plague which 
occurred in the villages was that in Anaplades, on the 6th of 
May ; and calculating from that time, the whole of Lefchimo 
would be entitled to general pratique within itself at the expira- 
tion of forty days, according to the established rules of quaran- 
tine, should nothing occur to prevent it. The cases of plague 
which occurred in the camp district, subsequent to the 6th of 
May, could not vitiate the character of the villages, nor affect 
them in any way, they being completely insulated, and wholly 
unconnected with the villages, as the camp district might be 
considered entirely under lock and key. 

On the 7th of June, I was called upon by the Major- General 
to prepare a certificate of the health of the district, before the 
issuing of the proclamation for free pratique within itself, by his 
Excellency the Lord High Commissioner's orders ; which cer- 



250 



PLAN OF MANAGEMENT 



tificate I forwarded to head-quarters on the 14th, as an official 
document for the government to act upon on the day following, 
when the pratique was to be proclaimed. It was couched in 
the following terms — viz., 

Egrippos, 14th June, 1816. 
I hereby certify that there is no apparent cause, either from sickness or 
unfinished expurgation or purification, or from the non-occupation of such 
houses and churches as were impested, to prevent my declaring the district of 
Lefchimo, under my superintendence, to he in a state of such health and 
security as to permit a general pratique and intercourse within itself. 

A. White, Surgeon to the Forces, 

Superintending the District of Lefchimo. 

In granting this public document, I was aware that the 
plague graves in four of the churches were not perfectly secured 
in the manner I had recommended, by placing tomb-stones 
over them; but the stones not having been sent down, this 
could not be done for the present. These churches, in as far 
as regarded the security of the public health, I knew to be per- 
fectly safe, as they had been proved ; but, in order to run no 
risk, they were kept locked up until the stones should be placed 
over the graves. A few days after, they were opened for the 
performance of divine service. 

On the 15th June, the proclamation was issued, granting free 
pratique to the district within itself to take place from the 17th. 
On this day the gates of the city were thrown open, and free 
intercourse allowed between it and the rest of the island, with 
the exception of the district of Lefchimo, which, although now 
in free pratique within itself, was not yet permitted any com- 
munication beyond its own bounds ; the principal cordon not 
being as yet withdrawn. But the free pratique within itself was 
perfectly uninterrupted ; and there was nothing now to prevent 
the people from going from village to village, and working at 
their usual occupations, the same as if no plague had ever 
existed among them. 

The Te Deum was ordered to be sung on the joyful occasion 
in all the churches of the island, with the exception of those of 



IN THE PLAGUE OF LEFCHIMO. 



251 



Lefchimo, which as yet were not used, as it was thought better 
to avoid all unnecessary congregations of the people for the 
present.* 

The inhabitants of Lefchimo were, as might be expected, 
highly pleased at the issue of the proclamation for general 
pratique within the district, but very clamorous at not being- 
allowed to have public worship performed in their churches. 

On the issue of the proclamation granting general pratique 
within the district, I received a letter from the Major- General, 
enclosing a copy of the general orders to the army, in which his 
Excellency was pleased to express " his high satisfaction at the 
good conduct of those employed on the plague service, during 
which every individual uniformly supported the exertions of his 
superiors, and in which the whole combination evinced in an 
eminent manner that, with discipline, judgment, and energy, 
the direst of all human calamities may be overcome." 

The people being now in free pratique among themselves, 
some dissensions took place respecting property ; whilst those 
bearing ill-will towards their neighbours sought and eagerly 
seized every opportunity of avenging themselves, and serious 
consequences were apprehended from the conduct of some of 
those daring and refractory miscreants. Instructions, therefore, 
were given to the military officers to prevent these acts of in- 
subordination ; and I requested that some legal authority might 
be sent down from the city to settle their differences. I myself 
had been often solicited to act as umpire on these occasions, 
and to endeavour to make up matters between them ; but I 
neither found myself qualified for such a task, nor, had I been 
so, would I have engaged in any such undertaking, having 
besides at the time sufficient employment of a different kind to 
attend to. 

The plague patients in the hospital being now all in a state 

* I remember, on my return to the city shortly after all quarantine restraints 
had been entirely removed, that I went to the procession and to the cathedral to 
hear high mass and the Te Deum on the joyful occasion; I found that Speridione, 
the Patron Saint of Corfu, got all the credit, but that no one else got any. 



252 



PLAN OF MANAGEMENT 



of convalescence, I ordered that establishment to be broken up 
on the 23rd June, and all the persons to be encamped under the 
same management as that observed with regard to the other con- 
valescents. I directed that all the impested bedding and other 
rubbish should be destroyed ; also that the people should white- 
wash and clean the hospital before they left it, preparatory to my 
sending in the expurgators to execute that duty finally. 

About this time, the troops forming the principal cordon at 
Messongie, to the number of about 300, became very sickly, in 
consequence of the remittent fever, which began to thin their 
ranks very fast ; and had already severely attacked Assistant- 
Surgeon Doyle, who was in charge of that post, rendering him 
incapable of duty. I was therefore reluctantly obliged to detach 
Assistant-Surgeon Gemillaro (who was soon afterwards attacked 
also) from the camp district to relieve him, appointing Mr. 
Sammut to his charge at the camps ; where, at the same time, 
however, there was very little other duty besides the daily in- 
spections of the convalescents. 

When I first inspected this cordon, soon after my arrival in 
the district, I foresaw that this post would not be tenable when 
the sickly season set in ; and I was convinced, from the low, 
marshy situation, and the unwholesome locality, that great sick- 
ness towards the autumn would ensue. Mr. Doyle reported to 
me weekly the state of the detachment, which I also myself 
frequently inspected, and I was quite concerned to see, that as 
the hot season advanced, so did the sickness increase among 
the troops. The cause was purely of a local nature — viz., 
marsh miasma, aided by heat ; and I was of opinion that if that 
post could be effectually maintained by occupying another 
situation, and thus the cause of the sickness be removed, the 
men would soon become more healthy. There was no other 
place, however, which they could occupy with equal advantage, 
particularly during the night ; and it was considered of the first 
importance to maintain the integrity of the cordon until the 
general pratique of the whole island was declared, which could 



IN THE PLAGUE OF LEFCHIMO. 



•253 



not be done, for fear of concealed effects, until at least forty 
days from the period of granting the general pratique of the 
district within itself had expired, which would be on the 27th of 
July. The Major- General, however, was obliged afterwards to di- 
minish the duties of the troops in consequence of the sickness that 
prevailed. I may here remark, by the way, that when this cordon 
was first established, some native militia were placed as a kind 
of first line in front of the British troops, the more effectually to 
cut off all intercourse with the impested district, and to detect 
those who might attempt to pass it. Lieutenant-Colonel Vogle- 
sang, of De Rolle's regiment, commanded at the cordon during 
the whole time ; and his exertions were of essential service in 
securing the rest of the island. 

Although everything had gone on hitherto as favourably as 
could be expected, from the rigorous measures adopted, and 
although the plague was apparently destroyed root and branch 
in all the villages, and what remained, entirely confined to the 
camp district ; and although the favourable state of the public 
health had warranted free pratique within the villages on the 1st 
of June, and now general pratique within the plague district on the 
17th June, we were not yet, from this favourable state of things, 
to relax or break down the system which was being carried on, 
and which was required to be kept up for some time longer, 
in order to place the security of the public health beyond all 
doubt. 

On the contrary, I caused it to be distinctly understood all 
over the district that the same rigid vigilance, and the same 
minute examination into every case of sickness, from whatever 
cause, was to be kept up ; so that, in the event of anything ap- 
pearing, it was to be immediately stopped by the proper means : 
and in the proclamation which announced the issue of general 
pratique within the district, the people were given to understand 
that the rigour of the quarantine laws was still in force in 
Lefchimo ; and that, although they were permitted to return to 
their usual occupations, they were expressly confined to 



254 



PLAN OF MANAGEMENT 



Lefchimo ; and neither allowed to go to sea in boats, nor to 
approach, much less to pass, the principal cordon, which cut 
off Lefchimo from the rest of the island. 

Notwithstanding that everything connected with the public 
health had gone on as favourably as possible, we had still one 
cause of dread ; and that was, lest there should still remain 
any concealed contagion. This all along had been a source of 
extreme anxiety to all concerned, and, in a certain degree, still 
continued to throw a doubt upon the future security of the 
island ; as it was impossible to ascertain whether everything 
concealed had been discovered. All who had been dismissed 
from the camps, from time to time, were invariably called upon 
to reveal everything they had concealed, and several made dis- 
coveries, and were rewarded for doing so; but we had no 
means of knowing whether they had nothing else secreted, nor 
was it possible to say whether such was the case or not. It 
was, therefore, proper to keep up the same system for some 
time longer, in order to see if any accident should occur. 

On the 25th of June, word was brought me by the orderly 
dragoon from Messongie, that General Phillips wished to see 
me at the cordon there. I immediately set off to meet him. 
After a good deal of conversation with him respecting the plague 
business in the district, he told me, to my surprise, that since 
he had left the city that morning, he had received a dispatch 
from Cephalonia, stating that the malady had also appeared in 
that island. He directed me, at the same time, to acquaint Mr. 
Tully that he would be wanted for that service ; and he gave 
me instructions to prepare all the camp equipage I could spare, 
and a corps of expurgators for that duty ; and to inform Captain 
Zerbi and Mr. Mazzenti that they were to accompany him. 
This was a very vexatious and unexpected occurrence, on which 
I had not calculated, but which demanded my immediate at- 
tention, and also prompt measures. I communicated these 
orders to Mr. Tully, telling him I would have everything in 
readiness for the embarkation by day-break, at Egrippos, on 



IN THE PLAGUE OF LEFCHIMO. 



255 



the following morning, as soon as the vessel should arrive to 
receive them on board. The next day, he and his attendants 
sailed for their destination in Cephalonia, to eradicate the 
malady there on the same principle as the one so happily 
acted upon in the district of Lefchimo, and now nearly brought 
to a close. 

I regretted extremely that two gun-boats had not been 
sent, one for the officers, and another for the corps of expurga- 
tors ; for as the quarantine of those people had not expired, I 
was apprehensive of some danger to Mr. Tully and the others, 
from the communication, which it was impossible to prevent in 
a small gun-boat.* 

On the departure of Mr. Tully, the medical charge of the lower 
district devolved on Mr. Goodison, assistant- surge on of the 
75th regiment, whose previous duties there had been very 
fatiguing and harassing, on account of the refractory conduct, 
and the deceptions attempted to be practised by the inhabitants. 

Having detached Mr. Tully on this duty, it became no longer 
necessary for him to report to me, but to the Governor of Cepha- 
lonia. I am therefore unacquainted with the details ; but as 
the existence of the plague there had been immediately ascer- 
tained and proclaimed, and no burning of the people's houses 
or other dreadful measures resorted to, from which such lament 
able effects had resulted in Corfu, the calamity was speedily 
suppressed, with great credit to himself and all employed on 
that service ; and thus another instance was given of the happy 
results of the plan of operations carried on in Corfu. 

* It was undoubtedly running some risk to send all these persons in the 
same vessel, particularly as regarded Mr. Tully and Captain Zerbi, but it is to 
be observed that I only sent those expurgators whose period of quarantine 
had nearly expired. Before they were allowed to embark, I ordered all their 
working clothes to be taken from them, and directed them to wash themselves 
in the sea ; after which they were supplied with clean clothes. This was all I 
could do under the circumstances, but I confess I was for some time anxious 
about the others. However, they all escaped plague, and on their arrival at 
Cephalonia, commenced their respective duties. 



256 



PLAN OF MANAGEMENT 



While these matters were going on, we had another alarm of 
plague from the village of Cuspades. A young man, 24 years of 
age, reported himself to Mr. Alexander as having a swelling in 
his groin, giving the following account of himself : — About a 
fortnight before, he had hurt his ankle by tying too tight the 
strings of his sandals. This produced pain and irritation, which 
ended in the formation of a small phlegmon, with a considerable 
degree of pain, extending along the inside of his thigh up to the 
groin. Not thinking much of the matter, he continued his usual 
labours without complaining, until the 30th of June, when, at 
last, he reported himself to Mr. Alexander. 

The febrile symptoms were extremely slight, and, indeed, not 
more than might have been expected from the sore, which healed 
soon after. I did not at the time think the case plague ; yet, 
under all the circumstances, I thought it prudent to remove the 
man himself and the other three persons of the family to the 
camp, placing them all in the same tent, where the former could 
be better taken care of than in his own village ; just as had 
been done with the boy from Marathea. Should the sore soon 
heal, and the bubo disappear, his three companions remaining 
all the while in health, I had then the strongest presumptive 
proof that there was no plague in the case; but had they, on the 
contrary, been taken ill, with symptoms of plague, it would have 
been conclusive that the case was really one of plague. Had I 
even had strong doubts upon my mind on the subject, I would 
not have kept them altogether, but have separated the sick man 
from the rest. I feel, however, that if the case had happened 
in the beginning of the calamity, I should not have been war- 
ranted in thus exposing by any experiment of the kind the lives 
of the other three persons, by keeping them in the same tent 
with the sick man. Until all doubts were removed respecting 
this case, the village was again ordered to be shut up ; and if I 
had ultimately been obliged to declare the case to be plague, 
the usual remedies must have been again put in execution, with 



IN THE PLAGUE OF LEFCHIMO. 257 

the additional precaution of collecting together the persons who 
were absent from it at the time, and to have escorted them back 
to it ; as also, further, to have placed in quarantine of observa- 
tion the houses which I could learn they had visited during the 
period of their absence, explaining to the people the necessity of 
these proceedings, and that of their strict obedience to the esta- 
blished orders. 

The bubo in the groin soon came to a suppuration, and at 
the end of three weeks was perfectly healed ; when all the party 
were sent home in good health, and all restraints removed from 
the village. 

A case of glandular enlargement in the groin occurred also 
in Vitulades. A man of a bad habit of body had what are com- 
monly called scorbutic ulcers in his legs. These, in my mind, 
satisfactorily accounted for the enlargement; and as he was 
otherwise in perfect health, no further notice was taken of the case. 

The first fortnight of a general pratique is always a most 
critical period, and demands the most vigilant watchfulness 
over the public health ; and in Lefchimo, from the circum- 
stances I have mentioned, it was peculiarly so. Yet it was 
important in every way to put the public health to the proof 
in the manner adopted; and if plague was really linking, to 
make it thus come out, and not cause alarm and confusion 
afterwards, when the restraints should be removed. In short, 
if the people had concealed effects, it was better they should go 
to them at once ; and if anything was to occur, the sooner it 
broke out, the better, when we were all on the alert, and ready 
to suppress the mischief. 

It is astonishing to observe how very soon a people forget 
the horrors of plague, which they have lately escaped ; and 
which, when over, appears but a dream ; as also, how soon 
individuals, who have experienced the greatest privation during 
the time, will all at once, from avarice and other motives, seem 
to set even ordinary precautions at nought. It was this that 



258 



PLAN OF MANAGEMENT 



made us dread the first fortnight of general pratique in Lefchimo, 
when the people we allowed to mix freely together, and do what 
they chose within the district ; and if they really had concealed 
effects, we had every reason to expect, as soon as they were at 
perfect liberty to do so, that they would go to look after them, 
and might possibly reproduce the calamity from this source. 
However, after the first fortnight or three weeks, if no plague 
appeared, we then naturally calculated that there was nothing 
to fear from concealed contagion ; for had there been any such 
hoards, it was to be expected that their owners would have gone 
to them, when if plague contagion had remained, it would have 
shown itself before the expiration of that term. 

I had frequently occasion about this time to notice in my 
despatches the appearance of the autumnal fever among the 
troops stationed in the different villages, which entirely inca- 
pacitated them from the performance of any military duty. It 
also attacked several of the inhabitants : the period of their 
convalescence was extremely tedious, from the great debility. 

The general symptoms were, violent headach, thirst, flushed 
face, rigors, pain of the back and loins, prostration of strength, 
loss of appetite, pulse quick and hard, with considerable heat 
and dryness of the skin ; heaviness over the eyes and a foul 
tongue, which was sometimes dry and furred. The bowels were 
generally confined, and when opened by medicine, the faces 
were often hard and dark-coloured. The debility, often after a 
few days' illness, was very remarkable. In some cases, there was 
considerable irritability of the stomach, with vomiting and 
purging, great oppression of the prcecordice, and restlessness. 
The symptoms terminated in fever, sometimes of the quotidian, 
sometimes of the tertian, and sometimes of the quartan type. 
The paroxysms in those fevers were often very severe, and gene- 
rally followed by a profuse perspiration. The appearance of 
the countenance was sallow, which in some of the patients 
assumed a yellowish hue. 

The fever both among the natives and the troops seemed to 



IN THE PLAGUE OF LEFCHIMO. 



259 



be tractable, and yielded to the usual mode of treatment, which 
was purges of calomel, with the extract of colocynth, saline 
purges, sudorifics, tonics, &c. I found the centaurium minus, of 
which there was abundance growing wild all over the district, 
a much better tonic than the cinchona, and it set better on the 
stomach. It was exhibited in the form of strong infusion, and 
as much of it was ordered to be taken at intervals as the stomach 
could bear. 

The fever seemed to me to be little, if at all, different from 
the autumnal fevers which I had frequently seen in Sicily, and 
in various parts of Spain and Portugal, during the Peninsular 
war, about the same season of the year ; and which, I believe, 
annually appear more or less in all those countries. 

It is worthy of remark, that although the fever was very severe, 
first at the cordon, and afterwards within the district, and that 
although the men became so much debilitated, even after a few 
days' illness, that only a few of them were again able to resume 
their military duties, the mortality was not so great as was 
expected, but, on the contrary, less than I have generally seen 
in fevers of that kind. 

I find, on looking into the report, that on the 9th of July, in 
the village of Argirades alone, the military detachment, con- 
sisting of nineteen men, had eight on the sick-list unfit for any 
kind of military duty, in a few days after the fever began to 
make its appearance. The other villages were nearly in the 
same state.* 

On the 10th of July, I had to notice a sudden death in the 
camp-district. A man belonging to the police-guard, who 
had been sent down from the city, had got drunk the night 
before ; and being thirsty after his debauch, drank a large 
draught of cold water, after which he ran into the sea to bathe 
himself and wash his shirt. He was suddenly taken ill, with 
pain in his stomach ; and before Mr. Sammut, who was within 

* The range of the thermometer about this time was generally from eighty- 
four degrees to ninety-three degrees during the day. 



260 



PLAN OF MANAGEMENT 



about two hundred yards of the place, could reach him, though 
immediately informed of the matter, he had expired. 

The body was examined after death by Mr. Sammut and Dr. 
De Greorgio, when the only appearances it exhibited were those 
which usually attend a case of apoplexy. The make of the 
man, too, who had a large head and a short neck, confirmed 
the opinion that he died of that complaint. 

The sickness prevailing among the British troops stationed 
in the villages, and nearly one-half of them being now quite 
unfit for military duty, it was thought proper to relieve these 
detachments by others from Captain Boccachampi's corps of 
Greek Infantry,* they being more accustomed to the unhealthy 
situations and more likely to escape the sickness, which was 
now become so general among our troops. These detachments 
were therefore withdrawn on the 11th of July, and concentrated 
in the healthiest place I could find in the neighbourhood of 
Perivoli, where I established a temporary hospital for their 
accommodation until they should be sent up to the city, and I 
appointed Mr. Muir to the charge. 

The duty of the medical officers was at this time very severe, 
from their being exposed to great fatigue and the hot weather, 
particularly in the examination of the health of the inhabitants. 
These inspections were not so frequent as they had formerly 
been, for by this time we were pretty well satisfied that no 
plague existed. Yet it was necessary that they should be seen 
once every day, in order to ascertain what was going on. 

The next day after Mr. Muir's appointment to the charge of 
the temporary hospital, he also was attacked very severely with 
the fever, and it was some time before he recovered. Several 
of the other officers were afterwards attacked by it. 

* Captain Boccachampi commanded a corps of Greek Light-infantry, which 
was of great use in the plague duties. He himself was the military com- 
mandant of Lower Lefchimo ; and Captain McDonald, of the 35th regi- 
ment, had the charge of the military duties in Upper Lefchimo. Both 
these officers were of essential service in keeping the refractory Greeks in 
order, as well as in arranging the other military duties throughout the district. 



IN THE PLAGUE OF LEFCHIMO. 



261 



This sickness, however, although severe, did not alarm us, 
as it was entirely owing to the unhealthy situation of the 
district and the season of the year, and quite unconnected 
with plague. If, however, this last disease had again appeared 
at the same time, I am persuaded that it would have been ex- 
tremely difficult, or perhaps impossible, in some cases, at least 
to discriminate between the one and the other. We must then 
have trusted to the distinguishing appearances of buboes, car- 
buncles, petechias, staggering, the peculiar cast of the coun- 
tenance, the state of the tongue, &c, all of which were absent 
in these fevers of which I am speaking. 

We had thus, in the district of Lefchimo, a remarkable in- 
stance of the cessation of plague, and almost immediately after 
this, the appearance of the annual fever. Yet so different were 
the symptoms, that one could hardly mistake the one for the 
other ; and whilst one decided case of plague would have caused 
very serious uneasiness and apprehension, the sickness over the 
district (which, however, I was informed was less than it had 
been in former years) excited no particular anxiety, except on 
account of the fever itself, knowing as we did that it was owing 
to local causes, and unconnected with plague contagion. What- 
ever speculative opinions may be formed, therefore, of bad fevers 
degenerating into real plague, (which I myself have always 
doubted, and believe to be utterly impossible,) yet here we 
have at least one instance to the contrary in the autumnal re- 
mittent fever of Lefchimo, where there was as wide a difference 
between the plague and it as between any two of the most 
opposite diseases. 



T 



262 



PLAN OF MANAGEMENT 



CHAPTER VIII. 

Expurgation of the pest-hospital — Urgent necessity, on account of the sick- 
ness among the troops, of speedily winding up the plague matters — The 
quarantine of the convalescents diminished from eighty to fifty days — They 
are not placed under restraint on their return home, as had been done 
with the suspected — Those who died of the prevailing fever not buried 
until the bodies were examined — The pest-hospital proved, as the other 
plague -houses had been — All quarantine restraints removed, and the district 
of Lefchimo placed in free pratique with the rest of the island — Some 
troops, and several medical gentlemen left for a short time in the district. 

The hospital having been broken up, and the convalescents 
and attendants all in camp, where they were now performing 
their quarantine, it was necessary to finish the whole of the 
expurgation by destroying all contagious matter contained in 
that focus of plague. People naturally view with horror a 
place in which such a dreadful disease has been concentrated in 
all its violence ; and at some periods of plague history, I believe 
it has not been thought possible so thoroughly to eradicate the 
contagion as to render such a place again habitable. Yet, 
in more modern times, we are accustomed to purify a pest- 
hospital with as much security to the public health, however long- 
it may have been used as such, as any other building in which 
plague has existed. 

A plague-hospital, however, certainly requires more care and 
minuteness in its purification, and perhaps also more time than 
ordinary plague-houses. The manner of purifying a plague- 
hospital is exactly the same in principle as that of any other 
place wherever plague has existed, — viz., by removing and 
burning every susceptible article to the very least rag, fre- 
quently washing with soap and hot water every part of the 
woodwork, &c, and afterwards repeatedly white-washing every 
room, and, in short, every hole and corner of the whole build- 
ing. After which it is to be repeatedly fumigated and venti- 
lated at proper intervals of six or eight days between each 



IN THE PLAGUE OF LEFCHIMO. 



26'3 



time ; and whilst the fumigations are going on, the rooms are 
to be kept closely shut up, as well as for several days after. 
The doors and windows are to be then opened, and the apart- 
ments afterwards to be thoroughly ventilated ; and this is to be 
repeated three or four times at least. Quicklime was scattered 
all over the floors of the hospital in Lefchimo, which were after- 
wards well washed with hot water, and every corner and every 
spot most carefully searched, lest any impested things should be 
concealed ; whilst every place immediately within the barriers 
and about the building was dug up, to ascertain if anything was 
hid in the earth. As an inducement to the expurgators to 
exert themselves in this respect, I promised them everything 
which they might discover worth the retaining. I am not 
aware that anything was discovered by them ; at which I was 
rather surprised, as I had a strong suspicion that some things 
of value were hid in or about the building ; for it is well known 
that the attendants on a plague-hospital, in spite of everything 
which can be said or done, will often be guilty of robbing and 
appropriating to themselves any valuables which the unfortunate 
patients may possess, particularly should these happen to die. 
But if the hospital is kept in the inviolate state which it ought 
to be, they can have no opportunity of conveying away their 
things. The only alternative, therefore, which they have left, 
is to secrete their plunder until they have an opportunity of 
removing it afterwards ; and I have no doubt whatever but that 
the plague, in some instances, has been brought back by these 
means. In the instance of the plague-hospital in Lefchimo, I 
am inclined to believe that neither the patients themselves nor 
the hospital servants had secreted anything ; at least, after the 
most diligent search, nothing was found ; nor was anything dis- 
covered in the possession of the hospital attendants when they 
were subjected to the complete spoglio, previous to their being- 
encamped. The palisading and the other woodwork around 
the hospital, which, when first erected, were well tarred, were 
afterwards white-washed before being taken to pieces, and then 

T 2 



264 



PLAN OF MANAGEMENT 



plunged into the sea for further purification, lest any contagious 
matter should have remained about them. They were finally 
replaced in the stores. 

I may here say something of the attendants on a plague- 
hospital. It is sometimes no easy matter, without having re- 
course to the severest measures, to control persons of this 
description. Being often felons, they are from character and 
principle the most worthless of mankind, who have already felt 
the heavy hand of stern justice for the crimes which they have 
committed ; and they are often rendered still more depraved 
by the very scenes to which they are accustomed. They well 
know that they hold life by a most precarious and uncertain 
tenure ; and that although they happen to be well to-day, they 
may be numbered with the dead or dying to-morrow. It is no 
wonder, then, that such men, perhaps naturally profligate and 
abandoned, should give full scope to evil and wicked propen- 
sities, as they are aware that, for the time at least, they are in 
some degree out of the reach of that punishment which they 
deserve, unless, indeed, they are shot or hanged like dogs, the 
very idea of being obliged to do which is dreadful and appalling 
in the extreme. 

The laws of quarantine are necessarily severe ; but for the 
sake of example to others, it will be found to be expedient at 
times to put them in full force against persons of this descrip- 
tion, for ordinary forbearance would be a mistaken clemency, 
which it were wrong and even dangerous to suffer. 

I had, in the plague of Lefchimo, the best reasons for knowing 
that the excesses which have so frequently disgraced pest 
establishments, did not take place there ; and I have no doubt 
that this was owing to the excellent arrangements, and the 
efficient state of the military discipline. 

Yet I do not mean to deny that irregularities and shameful 
conduct did not, on some occasions, take place among the in- 
mates of the pest hospital, which it was impossible entirely to 
prevent; as for a time at least they know they cannot be 



IN THE PLAGUE OF LEFCHIMO. 



265 



meddled with: and, indeed, if these irregularities had been 
greater than I afterwards found them to be, I could not have 
risked the health of other persons in punishing these miscreants; 
for be it remembered that I could not have again received back 
those persons whom I had ordered on that duty, without their 
performing a protracted quarantine as highly suspected; and 
when I read the shocking scenes which occurred during the 
plagues of Marseilles, Moscow, and in other places, it is pleasant 
to reflect that, comparatively speaking, we had little or nothing 
of the kind in Corfu. 

The time was now fast approaching when it would become 
necessary to send home the convalescents to their villages ; but 
preparatory to this, I made another minute inspection of their 
state of health, which was found to be perfectly good ; nor did 
I observe that any of the sores had again broken out. 

This was naturally an anxious period, on account of our not 
knowing at what precise time a person who had passed through 
the danger, ceased to be capable of contaminating others by 
mixing with them ; for on this head I am not aware that we 
have anything certain to guide us, except the old regulation, 
which directs such persons to perform forty days of foul quaran- 
tine, and afterwards forty days of clean quarantine. But if this 
rule were adhered to strictly, the first encampment, which had 
been formed on the 1st of June, could not have been released 
till the 20th of August ; and those encamped subsequently, on 
the 23rd of June, when the hospital was broken up, must have 
remained so till the 10th of September. 

The urgent necessity, however, which now existed of bringing 
matters to as speedy a termination as possible, and the im- 
possibility of maintaining the line of the cordon, where the 
troops were so reduced by sickness that they were unable to 
occupy it as formerly, without bringing fresh troops down from 
Corfu, which it was not judged proper to do, rendered it quite 
indispensable to try the experiment of shortening the usual 
period of quarantine. In case of its succeeding, it would be an 



266 



PLAN OF MANAGEMENT 



immense object gained ; if otherwise, we were all at our posts, 
and ready to apply the proper remedies. 

It is to be observed, however, that the danger arising from 
thus breaking through one of the most firmly established rules 
of quarantine, was lessened, when we consider that all the sores 
had been healed for some time previous to the people being- 
placed on their quarantine ; and although they could not be 
considered as perfectly cut off from the contagion of plague 
until that period was entered upon, after they had undergone 
the complete spoglio and purification, yet the risk of contagion 
remaining in the system may perhaps be considered as 
diminished every day from the time their sores were perfectly 
healed. 

I was convinced in my own mind that the management of 
everything had been conducted with as much positive certainty 
as could well be done, or as the matter could admit of. Yet I 
was not without apprehensions as to the final result of a plan 
of operations, which, if crowned with success, would place these 
matters on a more secure footing than they had hitherto been, 
and might serve as a lesson for the future in the management 
of this calamity ; whilst, on the other hand, if it should fail, it 
would go a great way to show that this terrible enemy was to 
be combated on different principles. 

On the 20th of July, the convalescents first encamped were 
liberated from camp, and sent to their homes, just fifty days 
after they had commenced their quarantine in camp, by which 
a period of thirty days was saved, which, according to the usual 
mode, must have been performed. 

The man with the fistulous bubo, and another belonging to 
De Rolle's regiment,* a most miserable object, whose feet and 
ankles had mortified and ulcerated from the consequences of 
the malady, were afterwards sent up, with some others, to the 
lazaretto of Corfu, to which the hospital attendants were also 



Vide Case X. 



IN THE PLAGUE OF LEFCHIMO. 



267 



removed for a short time, to finish their period of quarantine ; 
when the free pratique of the whole island was proclaimed on 
the 27th July. The unfortunate last-mentioned individual, 
though he recovered from the plague, had become literally one 
mass of disease. The bones of both his feet and ankles ap- 
peared to be carious. His knees and arms were so stiff that he 
could scarcely move about, or render himself the least assistance 
in any way ; and his life was quite a burthen to himself, nor 
was there any hope of his ever getting better, so as to render 
life even tolerable. He was the only one who suffered per- 
manently from the effects of this most deplorable malady. 
Being a foreigner, he was afterwards sent home to his own 
country at the expense of government, when his regiment was 
disbanded. 

Had the convalescents who were sent home been less numerous, 
or had they belonged only to two or three villages, they would 
have been placed in quarantine in their houses for a period of 
fifteen days; the same as had been done with the suspected 
when they returned ; but being so many, and from not fewer 
than eleven different villages, dispersed all over the district, this 
could not be done. To have again placed all these villages 
under restraint, after the return of their people, and after so long 
a period of free pratique among themselves, would have 
dispirited the inhabitants, and rendered them discontented; 
and it would have been presumed, at least, that the plague was 
not yet extinct, but that they were to be again subjected to all 
the inconveniences and vexations of quarantine, from which 
they had been for some time so happily relieved. Every one 
may have some idea of human feelings in a case like this ; but 
no one can truly know what they really are, without experienc- 
ing them, until every possible doubt is removed as to the con- 
tagion being entirely destroyed, and that none remains in the 
bodies of those who have passed through the disease ; and on 
this point we were as certain as in a case of the kind we 
could be. 



268 



PLAN OF MANAGEMENT 



The convalescents were, therefore, on their return, not placed 
in the same strict observation as that in which the suspected had 
been, for the reasons I have already stated ; but they were recom- 
mended to keep themselves quiet within their houses, as well as 
the rest of the families, until the dread and apprehension amongst 
their townspeople, which naturally still attached to them and their 
clothes, should wear off. There was no reason to fear that any 
of them would relapse again ; and from the length of time they 
had been in good health, we hoped at least that no contagion 
remained in their bodies to be communicated to others. As a 
medium measure, they were given in charge to the primates and 
deputies of the villages, with injunctions to these to keep them 
within their houses during this short and last probationary trial 
of fifteen days, which it was thought proper to make, not only 
of the state of health of these convalescents, but also of that of 
the families in which they resided ; and during that time the 
whole were carefully examined by a medical officer, who at 
times was accompanied by some of the magistrates, and the 
military officer commanding in the villages. As to myself, I 
had no apprehension on the score of plague. Yet, in so im- 
portant a matter as the public health, too much precaution can- 
not be used, and therefore these measures were carried into 
execution till the last. If sickness of a dangerous nature had 
occurred in any of the houses soon after their return, it would 
have been necessary to shut up such house, and perhaps 
eventually the whole village, until the nature of the disorder was 
perfectly ascertained ; but during the whole time that this trial 
was going on, nothing occurred among their families to excite 
even a suspicion that any plague contagion remained about them. 
All quarantine restraints wei'e removed on the 28th of July, when 
the district of Lefchimo was placed in free pratique with the rest 
of the island. 

Having still various duties to perform in the winding up of 
matters connected with the service, which nobody but myself 
knew well how to do, I did not return to the city for some short 



IN THE PLAGUE OF LEFCHIMO. 



269 



time after the issue of the general proclamation, which removed 
all restraints whatever, and the same intercourse all over the 
island was resumed as if no plague had ever existed. 

Some of the soldiers, and also of the inhabitants, had died of 
the prevailing autumnal fever, and I had established it as a 
general rule over the whole of the district, that the body should 
not be interred without being first examined by one or more of 
the medical officers and native doctors, until the former were 
sent up to the city ; and the case of every individual who fell 
sick, either of the fever, or of any other indisposition, was 
carefully watched over from its commencement till its final ter- 
mination; so that, with the practice which we now had had in 
plague, and our knowledge of the leading symptoms of that 
malady, it was not likely that if any case of positive plague had 
occurred, it would have escaped detection ; and, indeed, every 
death, from whatever cause it might happen, was perfectly 
known to me, and generally reported at head-quarters. The 
bodies of such as died of this fever, or of ordinary complaints, 
were not buried with quick-lime, as those of the plague victims 
usually were. 

However essential it might have been to have attended to all 
these matters, not only during the ravages of the calamity, but 
also on the winding up of the service, it nevertheless would 
have been quite impossible to have attended to all the minutiae 
in that strict manner which they required, unless there had been 
a sufficient number of intelligent medical gentlemen to execute 
these various duties. Hence the necessity of having a suffi- 
cient number of such, without which a service of this kind can- 
not be properly executed. 

The lazaretto, or pest-hospital, having now been well expur- 
gated, purified, and carefully examined by myself, in order to 
ascertain that it was so, it became necessary here, more than on 
any other occasion, that it should be occupied and proved, as 
all the other houses and places had already been. 

This hospital had formerly been a kind of magazine, and 



270 



PLAN OF MANAGEMENT 



was likely to be used again as such. As an hospital, it was by 
no means a convenient one in some respects ; but being the 
only tolerable accommodation which the place afforded, and the 
situation quite unexceptionable, it was employed as such, for 
want of a better. 

The obtaining proper persons to prove this building was our 
next object. The expurgators, who had had the plague either 
in Malta two years before, or those who had had it that season 
in Lefchimo, were obviously not proper persons for this proof, 
because, from their having previously passed through the disease 
at these periods, they must be considered as in a manner un- 
susceptible of being contaminated by the plague contagion, if 
any remained in the place; and it was extremely probable that 
if I had asked any of the inhabitants to hire themselves for this 
purpose who had never had the plague, and who were now enjoy- 
ing their liberty, that one and all of them would have refused 
even to enter a place which they could not view without a 
degree of dread and horror. I might have told them that I 
myself had entered it, and examined every part of it minutely; 
that from my personal inspection, it was perfectly well expur- 
gated and thoroughly ventilated. I might, indeed, have 
added, that my belief was (having made the experiment on my 
own person) that no real danger existed of contracting the 
plague by occupying it; still, however, I apprehend that it 
would have been impossible for me to have done away with the 
impression on the people's minds, that by thus occupying it, 
they would have been again impested, nor did I think that any 
reasoning with them on the subject would have been sufficient 
to remove the prejudices entertained by them respecting it. 

I had still in reserve for the performance of this duty a party 
of expurgators, who had arrived from Malta some time before ; 
some of whom I knew to have had the plague there, but some 
of them, I was informed, had never had any symptoms of that 
malady. On my examining these men, therefore, and making 
all the inquiries I could, I found that six of them had never 



IN THE PLAGUE OF LEFCHIMO. 



271 



had the plague ; consequently, the party altogether just an- 
swered the purpose for which I intended them ; for if any 
plague contagion remained in the hospital now about to be 
proved, it was more than probable that some of the six would 
be attacked ; but if, on the contrary, all of them continued in 
good health during this ordeal, I should have a strong presump- 
tive proof that all was right, and that no plague contagion what- 
ever remained in it. These men, therefore, who volunteered their 
services, and, indeed, were receiving a dollar a-day by their agree- 
ment, until they returned to Malta, were placed in the lazaretto 
on the 10th of July, so as to have the proof over on the 27th, 
when it was contemplated that all quarantine restraints whatever 
between the district of ] ;efchimo and the rest of the island were 
to be removed. During all this time, the party was, of course, 
subjected to the same medical examinations to which all those 
who had performed the like proofs in the houses had already 
been, and nothing like plague appeared among them. 

It was in this instance highly proper to employ the same 
persons in proving the hospital .who had expurgated it ; for if 
anything had afterwards broken out, it must have been owing 
to the imperfect manner in which that operation had been exe- 
cuted, and it was right that they should be the first to suffer 
from the effects of their own negligence. Yet, from my own 
particular examination of the whole, I was perfectly convinced 
in my own mind, that no real danger was to be apprehended. 
These men were therefore taken from the encampment to which 
they had been sent when the hospital was broken up ; previous 
to which circumstance, it will be remembered that they had 
undergone the complete spoglio ; and on their quitting the 
lazaretto, after the performance of this proof, they, like all the 
others, were well washed, fresh clothes were given to them, their 
old apparel having been all destroyed ; nor were they allowed 
to take anything with them besides their clean body clothes 
when they afterwards quitted the district, to finish the remainder 
of their quarantine in the lazaretto at Corfu. 



272 



PLAN OF MANAGEMENT 



The embarkation of the sick at the cordon formed no part of 
my duty, and was conducted under the directions of Mr. Por- 
teous, deputy inspector of hospitals, the senior medical officer 
in the Greek Islands. 

On the 26th of July, I received my last official letter from 
Major-General Phillips, enclosing a copy of the proclamation 
announcing that free pratique was declared between the district 
of Lefchimo and the rest of the island, and was to take place 
on the following day. On this day, the Major-General called 
at Egrippos, on his way to England, when he sent me an in- 
vitation to come on board his ship, then under weigh, to re- 
ceive free pratique in person.* 

It may be supposed that I lost no time in announcing these 
joyful tidings to all the district, or in distributing copies of the 
proclamation issued by government for that purpose, and which 
was happily to relieve every one concerned from a most harass- 
ing and trying duty, and myself from a load of care and 
anxiety, which it were difficult to describe, and also from 
personal fatigues, which had they continued much longer, I felt 
myself unable to have supported. 

At the time the free pratique was thus proclaimed, some of 
the convalescents last encamped, particularly the man with the 
open bubo, and the miserable object belonging to De Rolle's 
regiment, from their sores not being as yet quite healed, might not 
be considered to be altogether safe from the possibility of con- 
taminating other healthy persons, should they be allowed to mix 
with such. Neither these, however, nor the expurgators, whom 
I have mentioned as not having accomplished their quarantine, 
prevented the pratique from being carried into effect; boats 
having been sent down for these different classes, who were 
removed without their interfering with one another, to the 
lazaretto at Corfu, to finish it there ; after which, they also were 
liberated. 

I have thus given a detailed account of the plague of Lef- 
See Note F, Appendix. 



IN THE PLAGUE OF LEFCHIMO. 



273 



chimo, from its first breaking out till its final suppression on 
the 6tli of May, when the last plague accident occurred in the 
villages, and also of the police management during the whole 
proceedings, from its introduction till free pratique was pro- 
claimed on the 27th of July following ; when all restraints be- 
tween the lately impested district of Lefchimo and the rest of 
the island were entirely removed. 

The plan of management adopted on the occasion was not 
perhaps altogether novel at the time ; and it has since been 
carried into effect with the same evident advantages in Cepha- 
lonia. It will also be observed, throughout this detail, that the 
malady was all along considered as depending on contagion 
alone. Acting on that principle, the system was arranged, and 
the various combinations were formed, which so promptly 
arrested in its desolating progress and so speedily extinguished 
one of the direst of all human calamities. 

I have as much as possible avoided speculative opinions re- 
specting this malady, confining myself to the doctrine of con- 
tagion alone ; a doctrine very generally received, and of which 
I myself entertain no doubt; notwithstanding that there may 
be some circumstances opposed to its adoption, which are 
perhaps difficult to be explained away. Following up the 
opinion, therefore, that the plague depends on contagion, or 
contact in some way or other, and that it is propagated by that 
means, I have strengthened the doctrine with some important 
facts. Indeed, the whole of our proceedings in Lefchimo fully 
illustrate, and, I may say, quite demonstrate this point. 

From the scrupulous attention paid to all the various duties, 
(for nothing was left to chance,) I myself felt as confident of 
the perfect security of the island as in any aggravated case of 
the kind it could well be. But when we reflect on the extent 
of the concealment of the effects of the people, which, whether 
impested or not, it was impossible to ascertain, and the un- 
certainty of knowing positively whether everything had yet 
been discovered, I was not without some apprehensions on 



274 



PLAN OF MANAGEMENT 



that score, even when general free pratique was proclaimed. 
But I should not have been warranted on that account in recom- 
mending a continuance of the quarantine restrictions, for such 
would have caused the utmost dismay and alarm, not only within 
the island itself, but it would have also affected the commercial 
intercourse with other places. 

Yet, although the possibility of concealed contagion still 
threw a certain shade of doubt on our proceedings, (and indeed, 
this was the only doubt that now remained,) the various con- 
siderations already mentioned, rendered it indispensably 
necessary to bring matters to a final close in the manner now 
done. But in order to check speedily any evil that might un- 
fortunately start up, the Major- General, in his letter of the 
23rd of July, acquainted me that it was the intention, on with- 
drawing the British troops from Lefchimo, to leave a certain 
number of the Greek infantry there, under the command of 
Captain Boccachiampi, to watch over the public health, and 
also to keep order among the people. Assistant-Surgeon 
Alexander was also detained there for a short time, to reside at 
the head-quarters of the district, whilst other three Greek medical 
men were stationed, one at Clomo, another at St. Theodoro, 
and a third at Perivoli, to act under his orders, and report all 
occurrences. He was only a very few days in his new appoint- 
ment before he also was seized with the prevailing fever, and 
was obliged to be removed. 

One of the commissariat department, with the necessary 
establishment, was also left, for the purpose of provisioning 
the troops whilst they remained in the district, and also to supply 
the poor people for a fortnight after the free pratique was pro- 
claimed, after which it was expected that they would be able 
to provide for themselves. 

Of the tents which had been used, part had been sent to 
Cephalonia for the plague service there, and part was left standing 
for a few days longer, for further purification. Those occupied 



IN THE PLAGUE OF LEFCHIMO. 



275 



by the troops being perfectly free from plague, were taken 
along with them, and placed in the stores. The rest were 
afterwards sent up to Corfu. Part of them were nearly worn 
out, and were therefore burnt on the spot; but such as were 
serviceable, after being still further purified, were placed in the 
stores. 



PART V. 



ON THE CURE OF THE PLAGUE. 
CHAPTER I. 

Bleeding — Cold bathing — Diaphoretics — Emetics — Purgatives — Cordials — 
Opium — Saline mixtures — iEther — Camphor — Mercury — Blisters — Poul- 
tices — Bark. 

Among the whole class of diseases with which it has pleased 
Almighty God to afflict mankind, there is, perhaps, none so 
little understood in its mode of cure as that of which we have 
been speaking. Most other classes of diseases assume a fixed 
form, from which they only occasionally stray. Some organs 
are almost always affected in preference to others. Most other 
diseases, comparatively speaking, are slow in their progress, and 
fixed and determined in their symptoms, as well as in their 
mode of treatment. Thus, in pneumonia, we find pain in some 
part of the thorax, attended with more or less cough, and diffi- 
culty of breathing, with accompanying physical signs. We 
bleed and purge, and determine to the surface, and go through 
the usual plan of medical treatment, until the symptoms are 
moderated; and in cases of this complaint, if it has been taken 
in time and properly managed, we, generally speaking, succeed 
in curing our patients. 

In complaints of an inflammatory nature, we generally have 
recourse to the lancet and other means of depletion, in the first 



ON THE CURE OF THE PLAGUE. 



277 



instance, and if the proper remedies are timely applied, a 
large proportion of such complaints are cured. 

In cases of common fever, unaccompanied with inflammatory 
action, which form a considerable proportion of the diseases 
of mankind, we very frequently succeed in relieving our 
patients; and, finally, we carry them through perhaps a tedious 
disease, whilst in other fevers, more rapid in their progress, and 
more violent in their symptoms, we often cut short a disease 
* extremely alarming in its commencement. 

In the plague, however, it is different. Here the symptoms 
are so varied, and so many organs are implicated, such singular 
and sudden derangement takes place in the whole animal 
economy, that it may be termed (as I have already denominated 
it) a disease sui generis, participating, in some respects, in the 
character of all other diseases, yet perhaps essentially differing 
from them all ; and these strong traits in its character we see in 
the manner of its first introduction into any place, in that of its 
extension afterwards, in the unusual violence and rapidity of its 
symptoms, in a great proportion of cases at least, and in its 
determined resistance to any mode of treatment which has 
been hitherto recommended. Of this, the mortality which has 
always attended it, and the paucity of recoveries from it, which 
have, even under the most approved plan of cure, seldom ex- 
ceeded one in seven or eight, are, I regret to say, but too certain 
proofs.* 

* Mr. Tully, in his book, page 103, makes the recoveries from the plague in 
Lefchimo bear a proportion to the deaths of 1 to 4 ; but as I have every reason 
to believe that no regular returns were kept during the time he was in charge, 
I am bound to consider his to be an arbitrary calculation, and I think one at 
variance with the deaths in all plagues, taken as a whole. My own return, 
from the circumstances so often alluded to, may not perhaps be strictly cor- 
rect, but I formed it after a minute and tedious inquiry into the subject. If 
Mr. Tully had had any correct returns in his possession relative to the number 
of persons attacked by plague, the deaths, &c, he ought to have handed copies 
of them over to me for my guidance, when he was superseded in his charge 
by the orders of his Excellency Sir Thomas Maitland ; but I had no informa- 
tion that could bear him or myself out in this calculation. I am therefore of 

U 



278 



ON THE CURE OF THE PLAGUE. 



The rapid progression in the symptoms of plague, from the 
first appearance till death closes the scene, is truly remarkable. 
They are so little capable of being controlled by the medical 
art, and proceed towards a fatal termination with such rapid 
strides, and with such determined and unrelenting severity, that 
the physician becomes appalled ; for, on reasoning from analogy 
with other diseases, he finds himself disappointed both in the 
prognosis and in the curative indications ; indeed, so much is 
this the case, that he can hardly draw a comparison as to the 
final results betwixt plague and other diseases, from a similarity 
in the symptoms. 

It is not to be doubted that fevers of a very malignant type 
have occasionally made their appearance in several places, and 
have been peculiarly rapid in their progress, and that in their 
treatment the medical practitioner has been exceedingly embar- 
rassed ; as, for example, the fever which prevailed in Leghorn 
in 1804, that which has prevailed more than once on the coast 
of Spain, that which appeared in Gibraltar, &c. All these were 
violent diseases, difficult to be managed, and very fatal ; yet 
these are uncommon cases compared with ordinary fevers, and 
perhaps form exceptions to the general run of such. 

The plague, however, is uniformly violent in the train of its 
symptoms at its first breaking out, and has always been a rapid 
and fatal disease, from everything that we have heard or seen of 
it, wherever it has appeared; for the exceptions to the contrary 
do not detract from this general character, which it is allowed 
by all to possess. And although cases of plague do occur 

opinion that, in the calculation he makes, many persons admitted as cases of 
positive plague were only supposed cases, which were afterwards dismissed as 
cured of plague and sent to their homes, when, in point of fact, they never had 
the plague. This fact will at once explain the error he has fallen into, and is 
the only solution that can be given. 

The statement I give in page 187 is perfectly correct, with the exception 
that, in the class " in the lazaretto, sick and recovering-," several persons are 
there included as convalescents which never had been cases of plague, and 
which ought not to have been placed there. 



ON THE CURE OF THE PLAGUE. 



•279 



occasionally which are so slight as scarcely to incapacitate the 
persons attacked from the performance of their usual employ- 
ments, while others linger for a considerable time betwixt life 
and death, and finally get over the complaint at last; yet these 
are rare cases, and can hardly be said to form exceptions to the 
character which I have said it possesses. 

Not only is plague a violent disease, which rapidly goes on to 
a fatal termination, but, unfortunately, it is so little under the 
control of medicine, that we can seldom be said to alleviate the 
symptoms ; and certainly it has hitherto baffled every method of 
cure which has been recommended, notwithstanding that many 
have recovered, and that the recoveries have been attributed to 
a particular mode of treatment. 

How, when it has once got into a family, it should continue 
its deadly strides without interruption from one person to 
another, until the whole family becomes extinct ; and when it 
has appeared in another, perhaps equally numerous, how it 
should only fix on one victim, all the rest escaping, who have 
been in the closest communication with the sick, we have no 
means of explaining in a satisfactory manner, without adopting 
the hypothesis of peculiarity of constitution, or of their being insus- 
ceptible at the time, and thus able to resist its attack. This, 
however, does not occur in plague alone, but also in other 
complaints. 

From my own experience, and from everything which I have 
heard or read on the subject, I believe the plague to be a disease 
less under the control of medical treatment than any other with 
which we are acquainted ; and T am afraid that some medical prac- 
titioners have taken to themselves more merit in the cure of this 
disorder than they were fairly entitled to, and have given them- 
selves credit for what nature alone has effected. Yet I would 
not be understood to say that we are therefore to give up plague 
cases as lost and hopeless, and to trust everything to the 
powers of nature. I by no means think so, being fully persuaded 
that by proper and judicious treatment much is to be achieved. 

u 2 



280 



ON THE CURE OF THE PLAGUE. 



And although in the overwhelming cases which so often occur, 
and which run to a fatal termination with such awful rapidity, 
which nothing we know of can arrest, the patient being carried 
off before any medicines can have effect, yet happily this is 
not always the case ; and in the milder cases much is to be done 
by the judicious practitioner. 

Without entering into any discussion on the merits of the 
plan of treatment recommended by a late writer on epidemic 
diseases, and which, if not carried into effect precisely in the 
same manner as has been recommended by him, has been tried 
by others, and found wanting ; yet I fear I am warranted in as- 
serting that hitherto the plague stands one of the opprobia mede- 
cince ; and that we are not in possession either of any specific for 
its cure, or of any prophylactic for its prevention, beyond that 
of non-communication. 

I have no doubt that part of the mortality incident to plague 
hospitals, particularly in European countries, may be attributed 
in a certain degree to neglect, not of medical treatment, but of 
the ordinary attentions which sick persons necessarily require. 
This is, indeed, much to be lamented, but very difficult, if not 
quite impossible, to be altogether remedied. No medical prac- 
titioner, however respectable he may be for his talents and 
humanity, can do everything himself; and the servants under 
his orders, whom he is forced to have, are often of the very worst 
possible character, and will not always bestowthat care and atten- 
tion on his patients which they may require, or which he knows 
would in other complaints be performed without any reluctance 
whatever. In other hospitals, a nurse or orderly attends the 
patients with assiduous care and anxious kindness, because 
these know such to be their duty, and because they know also 
that their character will suffer from neglecting their patients, or 
perhaps the dread of punishment or self-interest stimulates 
them to execute their orders with precision. In private life, 
love and affectionate regard soothe the distresses of the bed-side 
of the suffering individuals. But such feelings, I am afraid, 



ON THE CURE OF THE PLAGUE. 



281 



seldom actuate the attendants on a pest hospital, where death 
makes such awful strides, where everything around is full of 
horror, so as to supersede all other feelings ; where the attendants 
are often felons, and where even the greatest kindness and 
humanity, though exerted, can often be of no avail. 

With these preliminary remarks, which I think it necessary 
to introduce here, I come to the treatment of this disease as 
adopted in the plague of Lefchimo. And here I have to regret 
that no fixed plan seems to have been determined upon, and 
to have had a fair trial given it by the different medical gentle- 
men who were in the immediate charge of the pest patients, at 
the first ebullition, when the disease was most violent, and 
the mortality the greatest. 

In a disease such as plague, which has hitherto resisted the 
ordinary rules of medical art, some decided plan of cure should 
be adopted, and have a fair trial ; when, even if it should be un- 
successful, we gain at least information by its very failure, and 
it may serve for a beacon to guard us against following a similar 
practice in future ; whilst, if successful, a road is made for us to 
follow hereafter. 

It will, perhaps, be alleged that in a disease so variable, 
and accompanied by such a diversity of symptoms, as we find 
described by authors, no fixed plan of treatment can be well 
laid down. This is, perhaps, doubtful; for although plague 
may be modified by circumstances, yet I conceive it to be es- 
sentially the same disease wherever and whenever it makes its 
appearance. 

I am not, however, prepared, from my own experience, to 
say what plan of treatment ought to be pursued. Yet whatever 
that may be, it must be of an active nature, so as to have as 
immediate an effect on the constitution of the patient as pos- 
sible, and thus counteract and arrest the violent train of symp- 
toms with which the disease is ushered in ; for unless this 
desirable end can be effected, and that very speedily, the great 
probability is that the patient will be carried off. I do not 



282 



ON THE CURE OF THE PLAGUE. 



imagine, however, that in some of the violent cases any prac- 
tice, however active or judicious, will be availing ; as, for ex- 
ample, in such patients as become suddenly ill, and continuing 
rapidly to become worse, are carried off in a day or two from 
the time they began to complain, perhaps in a few hours. In- 
deed, in such cases as these, I question whether anything can be 
done, or any kind of treatment could possibly save the patient. 

On the hypothesis of the dependence of plague on plethora, 
followed by congestion and high inflammatory action, depletion 
by the lancet has been strongly recommended, and in some 
cases earned as far as it could well be done, not only without 
benefit in arresting the progress of the disease, but, I am afraid, 
in some instances at least, in hastening the fatal termination. 

That the plague depends on plethora was the opinion of the 
late Dr. Whyte, who, when he was permitted, at his own solici- 
tation, to enter our pest-hospital at El Hamet, in Egypt, .to 
exert his skill in curing this baffling and intractable disease, 
commenced his practice by bleeding indiscriminately all the 
patients in the hospital, to the number of sixteen, exclusive of 
Mr. Price, the principal medical officer there, who was at the 
time ill of plague, but who would not submit to have that 
operation performed upon himself. 

On the day following — viz., on the 3rd of January — he again 
repeated the venesection on four of the patients, and very 
copiously. The patients who had been bled the evening before, 
as well as those who were bled next morning, became evidently 
worse towards the evening of the same day. He gave a dose 
of rhubarb and senna to each. The same night he repeated 
the venesection on three of the four patients whom he had bled 
in the morning, when two of them died during the operation, 
and the third about an hour after.* 

On the 6th, Mr. Rice, hospital-assistant, now surgeon to the 
forces, and a Mr. Grisdale, assistant-surgeon in the service of 

* I have no note of the particular medical treatment of these cases. 



ON THE CURE OF THE PLAGUE. 



283 



the Honourable East India Company, were ordered to do 
duty in that hospital, and by this time the remaining thirteen 
patients above mentioned had died. 

These particulars, and also a detailed account of Dr. Whyte's 
own case, were furnished me by Mr. Rice, some short time 
after he was relieved from the plague duty, and I inserted them 
in my journal, which I kept at the time I was in Egypt. The 
doctor's case I do not think it necessary to repeat here, as 
it has been already noticed by Sir James McGrigor, in his 
" Medical Sketches." 

Here we have proof, as far as this instance goes, of the failure 
of the plan of depletion by the lancet in plague ; and if sudden 
and copious bleeding had been sufficient to arrest the disease 
among the doctor's patients, the greater part, if not the whole, 
of whom were natives of India, I think it is reasonable to sup- 
pose that some benefit at least would have been experienced 
here. This, however, did not appear to be the fact. 

Yet, perhaps, the indiscriminate use of the lancet in all these 
cases was not judicious, even allowing the theory to be just ; 
and without having any idea of reflecting on the theory or 
practice of Dr. Whyte, granting that the latter was exactly 
such as related to me by Mr. Rice, which I have no reason to 
doubt, I apprehend, that although it might have been right and 
proper in some of the cases to deplete largely, yet I think it 
not likely that all of the cases required to be bled — as, for 
example, if any of them had buboes going on favourably towards 
suppuration ; for it is reasonable to suppose, although I am 
not fully acquainted with the particulars of the cases, that they 
could not haye been all precisely in the same state nor of the 
same intensity, but that, on the contrary, although all were 
plague cases, yet were they in different stages of the malady, 
and consequently required in some degree a different mode of 
treatment, and what may have been considered to be sound 
practice in one case, might have been prejudicial in another. 
The hypothesis, therefore, however correct, was not equally 



284 



ON THE CURE OF THE PLAGUE. 



applicable to all stages of the disease ; for we know well that 
even in complaints avowedly caused by plethora, the patients 
will not in all the stages of the disease bear equally well the 
abstraction of blood nor other debilitating treatment, as they 
would have done at the beginning. Thus, in some fevers of 
high inflammatory action, the patient at the beginning will bear 
the abstraction of blood and active purgative medicines not only 
without his strength thereby suffering, but with decided advan- 
tage in the complaint, whilst the same mode of treatment in an 
after period of the disease would not be admissible. 

It has been mentioned to me, that in the plague of Lefchimo, 
Dr. Piccoli frequently used the lancet, but not with success, 
and he afterwards abandoned that practice.* Captain Currupi, 
of the Ionian Greek Infantry, was bled, but without benefit, and 
he died the third day. 

With regard to the propriety or impropriety of venesection 
in plague, I have nothing to say from experience, having never 
tried that practice ; but my opinion is, although I do not mean 
to deny that cases may occur in which bleeding may be proper, 
yet that such cases are not frequent, and that, generally speak- 
ing, it is not admissible. It has been found, that in cases 
where from the state of the pulse and the other symptoms it 
was thought necessary to abstract blood, even a small bleeding, 
which in other complaints would have had little or no effect, 
has caused in the plague so much debility, that the patient 
sank from that hour.f 

Dr. De Georgio was at one time in the practice of bleeding in 
the plague of Lefchimo, but he afterwards gave it up. He re- 
marks, in his report to me : " Osservai die l'emissione di sangue 

* I regret that I am obliged to speak only from hearsay report of Dr. Pic- 
coli's practice in the plague, and not from written documents. 

f Dr. Hodges, speaking of the effects of bleeding in the plague of London, 
says : " I will not, however, deny but that there may possibly be circum- 
stances in malignant and pestilential fevers which may justify phlebotomy, 
as when it is done for revulsion sake, as in too great a flux of the menses ; but 
in genuine pestilence it is not to be meddled with. There is but one, as I can 
remember, who survived it in the late sickness." — Hodges' Loimologise, p. 157. 



ON THE CURE OF THE PLAGUE. 



•285 



e stata mortale per gli appestati. II sangue non coagula. La 
raggione e evidente, esistendo una totale dissolutione di umori, 
il sangue non puo mai coagulare." This very circumstance, the 
dissolved state of the blood, which has been noticed by so many 
authors, and is therefore not to be doubted, convinces me that 
the practice generally is not to be adopted with impunity ; and 
I am still further confirmed in this opinion when I consider 
that natural haemorrhages, from whatever part they come, are 
seldom beneficial, but, on the contrary, are very often the fore- 
runners of death. In the plague, therefore, haemorrhage is not 
to be considered as a salutary effort of nature, as we observe it 
to be on other occasions, but as a proof, and a sad one, of the 
failure of the powers of nature, and, I had almost said, an un- 
erring symptom of approaching dissolution. 

The hospital in the camp district being situated on the edge 
of the sea, afforded us the best means for the trial of sea-bathing 
in this complaint, particularly at its commencement. In a 
variety of cases it was adopted ; in some of them with evident 
good effects, more especially in those cases where there was a 
high degree of action, attended with delirium and affection of 
the head. It was wonderful, on those occasions, to remark 
the sudden alteration which sometimes took place. From a 
state of almost frenzy, the patient became on a sudden calm 
and tranquil after immersion in the sea. On a return of the 
paroxysm, the immersion was again had recourse to, and with 
the same relief. Some of the patients, in a state of furious 
delirium, escaped from the hospital, which was open only on 
the sea-side, and threw themselves into the sea, from which 
they were taken out more tranquil. In one patient, the paroxysm 
came on with furious delirium approaching to madness. He 
was frequently taken out and bathed in the sea, which always 
had the effect of rendering him more calm and composed. This 
poor man, however, was carried off in one of these dreadful 
paroxysms, the recurrence of which could not by any means be 
prevented. 

Cold bathing I consider, therefore, an useful auxiliary to 



286 



ON THE CURE OF THE PLAGUE. 



other remedies in the cure of this disease ; and several of 
those who recovered had been subjected to this plan; but 
I must also state that many of those died on whom it was tried. 
Perhaps the indiscriminate use of the cold bath is improper ; 
and I give it as an opinion that it ought to be confined to 
cases of high febrile action, with heat of skin ; but where a 
contrary state exists, attended with stupor, shivering, and other 
symptoms, indicating great debility, I conceive it would do harm, 
as I have reason to believe has happened on some occasions. 

I have mentioned dryness of the skin as symptomatic of 
plague ; and this I remember was particularly remarkable 
among my patients in Egypt ; and there it was so very obstinate, 
that I could not succeed in removing it by any sudorific which 
I employed. Indeed, my opinion at that time was, that if I could 
have but produced a free perspiration, I should have succeeded 
in curing the disease. Although this dryness of the skin is not 
an uncommon symptom in plague, I apprehend it was more 
common than usual there, from the naturally dry state of the 
skin among the inhabitants of India in the cold weather which 
prevailed at that season of the year, and which they seemed to 
feel very severely, so that their skins were dry like parchment. 

I could not learn that the warm bath was used at any period 
in the plague of Lefchimo ; but various diaphoretics were used, 
which in many cases had the effect of bringing on a free per- 
spiration. In some of the cases, this appeared to be of service, 
but it was not attended with that benefit which I had formerly 
expected, or which we are accustomed to expect in other com- 
plaints ; for many of the patients were carried off* in these violent 
paroxysms after a very profuse perspiration had come on. Yet 
a moist surface was considered to be favourable, and was com- 
mon among those who recovered. 

The medicines of this class which were chiefly used were 
the pulvis antimonialis, the pulv. ipecacuhanse comp., Dr. 
James's powder, the vinum antimonii, spiritus mindireri, and 
various decoctions and drinks which the medical gentlemen 



ON THE CURE OF THE PLAGUE. 



287 



were in the habit of using in their practice in the country. 
Sometimes opium was combined with these sudorifics, and 
sometimes they were given alone. Often the James's powder 
or the pulvis antimonialis was given, with small doses of 
calomel. 

In the irritable state of the stomach, so common in plague, 
the exhibition of antimonials was inadmissible, from the violent 
degree of vomiting which they are apt to produce. And even 
in the less irritable states they required to be given with caution, 
and combined with opium. They were also, when the bowels 
were confined, given mixed with calomel. The pulvis ipeca- 
cuanha compositus seemed to sit better on the stomach, but in 
general its operation was less certain than that of the antimonials. 
Yet even these last not unfrequently failed in producing free 
perspiration, although administered with all due care ; and in 
those cases the patient was carried off with the skin remaining 
obstinately hot and dry from the beginning. It is here to be 
remarked, however, that although it is desirable to produce 
diaphoresis, yet at times, after very violent paroxysms, the skin 
was left in a clammy, moist state, which not only was not bene- 
ficial, but was a forerunner of death.* 

It is, notwithstanding, proper to observe that in a pest hospital 
it is next to an impossibility, from the negligence and careless- 
ness of servants, to keep up the perspiration after it has once 
been induced which the case requires, and from which alone 
benefit is to be expected ; nor can the medical attendant, how- 
ever able he may be, as well as anxious for the recovery of his 

* On this subject, Dr. Russell remarks, page 157 : " The mild sudorifics 
exhibited in the manner above described every five or six hours very often 
produced no perceptible increase of perspiration. At other times, a sweat was 
observed to follow ; but as natural sweats were at certain periods incident to 
the disease, the sweat was not rashly to be considered as always produced by 
the medicine that had been given. Where the natural disposition happened 
to coincide with the operation of the sudorifics, they no doubt might assist; 
where that predisposition was absent, they were not of power sufficient to 
cause a diaphoresis." 



288 



ON THE CURE OF THE PLAGUE. 



patient, be supposed to attend to everything himself in person ; 
and he must therefore trust at times to those under him. This 
is an evil to be deeply deplored, but for which, though as much 
to be guarded against as possible, there is probably no effectual 
remedy. Servants may at times be found to perform certain 
offices, but there are many acts of real kindness and atten- 
tion towards the sick that must be voluntary, and cannot 
be compelled. There is often, too, a dread of contracting 
the disorder among attendants in a plague hospital, by the 
performance of duties, when they themselves have not passed 
through the disease, and which, under other circumstances, they 
would not hesitate to do. This is particularly the case with 
Europeans, and which the true Mussulmen repel with indig- 
nation. It was this, no doubt, which induced Dr. Assalini to say 
— " If I were doomed to be attacked by the plague, I would by 
far prefer being in the hands of the Turks than in those of the 
Europeans."* 

From the often irritable state of the stomach, emetics 
were not in general used ; nor, indeed, could they well be ad- 
ministered with much prospect of benefit where vomiting formed 
a prominent symptom of this complaint. In these cases, 
the great desideratum was to allay this distressing symptom, 
which not unfrequently continued to the last, in spite of every- 
thing that could be done to restrain it. 

Emetics were, however, given when there was loathing and a 
a sensation of fulness of the stomach ; and they often relieved 
the intolerable headach. Tartar emetic was employed by Mr. 
Saisset even when severe vomiting was one of the symptoms. t 
They frequently had full effect in evacuating the contents of the 
stomach ; but I am not aware that in any one case the symptoms 
were cut short in the way we occasionally see done when they 
are given in cases of fever. 

Various purgative medicines, such as salts, compound extract 

* Assalini's Observations on the Plague, page 89. 

f See Mr. Saisset's Cases, I., II., III., V., IX., X., XI. 



ON THE CURE OF THE PLAGUE. 



289 



of colocynth, rhubarb, oleum ricini, were employed to empty the 
bowels ; and they had that effect without seeming to be pro- 
ductive of any permanent benefit, although they often relieved 
the distressing headach. If purgatives were persevered in, they 
debilitated the patients, and produced a diarrhoea, which was ge- 
nerally fatal. Indeed, diarrhoea, from whatever cause, was almost 
always unfavourable. Costiveness, unless removed by medicine, 
was not unfrequent throughout the disease, but I do not know 
that it was an unfavourable symptom, and when removed by 
aperient medicines, the general train of symptoms could scarcely 
be said to be relieved thereby. 

Cordials, laudanum, and saline mixtures, aether, and other 
stimulants were given to allay the irritable state of the stomach. 
Pure opium was also given with that intention, and to procure 
sleep, but it seldom had the effect of quieting the disturbed state 
of the sensorium, which seems to be materially concerned. In 
order to counteract the great debility, wine was frequently given, 
sometimes with and sometimes without opium. 

In the plague of Egypt, I was of opinion that if I could keep 
my patients under the influence of wine and opium for some 
time, I might be able to control the disease. But after a fair 
trial in several cases, all of whom died, I gave up that practice. 
Mr. Adrian, one of the British medical officers in Egypt, was 
also of that opinion, and tried it, but was equally unsuccessful, 
and also abandoned it. 

Camphor was also given, and, it was thought, sometimes with 
advantage. 

Calomel was frequently given by itself, and also combined 
with purgatives. Other preparations of mercury were also 
used; but, I apprehend, they were not given with regularity, 
and in a continued form proportioned to the intensity of the 
disease, so as quickly to affect the system; for I am persuaded 
that whatever medicines or mode of treatment may be found 
hereafter to be successful in the cure of this disease must be 
such as are capable of quickly affecting the constitution; for 
unless this can be done, and that speedily, so as that the violence 



290 



ON THE CURE OF THE PLAGUE. 



of the disease is counteracted with all possible expedition, a 
great proportion of the patients will be soon carried off; so 
rapidly does plague run its course, and the patient dies. 

Mercury has for a long time been a favourite remedy in the 
plague, and I have no doubt is one of the best medicines 
which can be employed. But I fear it has not always been 
given in the proper manner, so as quickly to affect the con- 
stitution; and in most cases it must be given internally, in 
preference to the ointment, (indeed, some cases may require it 
to be exhibited both ways,) as a great proportion of the patients 
are unequal to the task of rubbing it in properly, being either 
too weak or incapable from other symptoms of doing so; and 
we cannot trust this duty to the hospital servants, for it is not 
very likely that even the best of them would be willing to rub 
in mercury for a plague patient in the proper manner required. 
We know even in private life how very reluctant some servants 
are to perform such an operation, with bladder or oil-skin gloves, 
and how imperfectly and carelessly it is done even when 
strong inducements are held out for performing it. We have 
therefore much stronger reason to suspect that it will not be 
properly done on occasions like those I am speaking of. 

It is on this account, therefore, that when mercury is used, it 
ought to be exhibited in that form which is the least trouble- 
some, and likeliest to have the most immediate effect. When, 
however, cases occur in which the head is clear, and the 
strength but little impaired, the patient himself should use the 
ointment, which in some respects is perhaps better than any 
other preparation of that mineral. 

Mercury was employed in the cure of the plague in Egypt, 
and was thought to be of service. I tried it also, but the result 
of my experience does not enable me to say much in its favour, 
as most of the cases died before I could affect the mouth, con- 
sequently, I do not think it had a fair trial with me. But Sir 
James McGrigor, then chief medical officer of the Indian army, 
to whom the plague reports of that army were sent, speaks 



ON THE CURE OF THE PLAGUE. 



291 



highly of it, and gives a variety of cases in which it was used 
with advantage. 

Dr. McLean, in his elaborate work on Epidemic Diseases, 
vol. ii. chap. 48, speaking of the cure of plague, and conceiving 
it to be a disease of the circulating system, and an affection of 
the brain and nerves, recommends the use of calomel and 
opium. 

He says, in page 461 — "For the most ordinary combination, 
then, and supposing it a mean affection, I would prescribe six 
grains of calomel and two grains of opium every two hours, 
day and night, until the disease was overcome, which I should 
expect to happen, under a due regularity in the administration 
of the remedies, within forty-eight hours, if the treatment was 
commenced on the first or second day of the attack." And in 
the following pages he says — " In the more severe pestilences, 
supposing the relative degrees of the affections of the different 
systems or organs to observe the usual proportions, it will, of 
course, be necessary proportionally to increase the force of 
each of the agents employed beyond what was adapted to the 
mean degree of the disease ; as, for instance, seven grains and 
a half of calomel and two grains and a half of opium, nine 
grains of calomel and three grains of opium, twelve grains of 
calomel and four of opium, for the three next higher degrees." 

"On the other hand, in those degrees of pestilence below 
the mean state, the relative intensity of the affections of the 
different organs not varying, the quantities may be reduced to 
five, four, three, two, and even one grain of the former agent 
and one and two-thirds, one and one-third, one, two-thirds, 
and one-third of a grain of the latter, for the five next inferior 
degrees." 

In addition to the calomel and opium, he recommends am- 
bulating blisters, and the bowels to be kept open by enemas of 
castor oil and salts, and having mastered the disease by these 
means, he directs the gradual subduction of the remedies em- 
ployed. 



292 



ON THE CURE OF THE PLAGUE. 



Without taking upon myself to give an opinion on this mode 
of practice, I apprehend that the system of the human body is 
not so mechanical, nor the different grades of the disease so 
distinct as the Doctor would lead us to suppose; for it is not 
uncommon to observe that persons who had no very extraordi- 
nary symptoms at the commencement, have been dead within 
twenty-four or thirty- six hours from the time they first began 
to complain. 

Happy will it be, however, for posterity if the mode of treat- 
ment which he recommends, and which he mentions as so 
successful in the hospital of the Seven Towers in Constantinople, 
should be found to be equally, or even nearly so, by those who 
may hereafter employ it ; for if this should be proved by future 
experience, a disease which has hitherto baffled the skill of the 
most expert and ablest physicians, and which has excited the 
researches of medical men in no common degree, will become, 
comparatively speaking, tractable and innocent. But until it is 
thus confirmed, no decided opinion as to its merits can be pro- 
nounced. 

On this subject, I have only further to say, that as all the 
modes of treatment hitherto adopted have been so extremely 
unsuccessful, it deserves a fair trial, and had I known of the 
plan which Dr. McLean recommends at the time I was 
employed in Corfu, I would have given it a fair trial.* 

Blisters were frequently employed, particularly on the site of 
the bubo, the formation of which appears to be an effort of 
nature. When the bubo was hard and indolent, they some- 
times seemed to accelerate the process of suppuration ; in rare 
instances, they seemed to repel it. But it is always desirable to 
bring on suppuration as quickly as possible, and this once 
effected, it was a favourable symptom, but the contrary when 
it continued hard and painful, along with the other train of 
symptoms. 

With the view of assisting the efforts of nature in bringing 
* See Dr. M'Lean on Epidemic and Pestilential Diseases. 



ON THE CURE OF THE PLAGUE. 



293 



the buboes to suppuration, emollient poultices were applied 
Mr. Saisset, however, was of opinion that for this purpose they 
were inferior to blisters. 

In some cases, the actual cautery was applied to the bubo ; 
but on account of the excessive pain, and other circumstances, 
this mode of practice was not long persisted in. 

I may here mention that the application of the actual cautery 
to the venereal bubo is a very common practice among the 
Sicilian surgeons, and often with good effect in causing it to heal 
rapidly. 

I must here remark, what I believe I have omitted to mention 
elsewhere, that at first the skin over the pestilential bubo, even 
when it is of a considerable size, is often not discoloured, and 
is loose over the diseased gland. It in this respect is very dif- 
ferent from the venereal bubo, which, even when small, is early 
discoloured. When, however, suppuration comes on in the 
pestilential bubo, it becomes also red and discoloured, which 
is considered favourable, particularly when along with this the 
fever begins to decline. This last circumstance I find con- 
firmed by Dr. Russell, in page 115 of his excellent work. 

The application of poultices to the buboes was in general 
use, and when there was any disposition towards a kindly sup- 
puration, they accelerated that event. 

Sometimes the buboes burst naturally; at others, they were 
opened by the lancet as soon as suppuration was established. 
Afterwards they were dressed as common sores. 

Carbuncles were treated in the usual manner. Some of them 
were very large. I saw the cicatrix of one on a woman's breast 
which was larger than the palm of my hand. 

The pulvis cinchonse was frequently given with and without 
wine, but it only seemed to be of service as a tonic, when the 
violence of the symptoms had passed over. 

In the after medical treatment, during the period of convales- 
cence, there was nothing peculiar or differing from what is 
usually recommended in the recovery from fever. 

x 



294 



ON THE CURE OF THE PLAGUE. 



Sir James McGrigor has mentioned in his " Medical Sketches" 
that the nitric acid both externally and internally was of ser- 
vice ; in the former case, it was used as a warm bath, and in the 
latter, it was given diluted with water in as large quantities as the 
patients could be prevailed upon to drink. In some cases, it 
produced ptyalism where mercury had failed. The nitric acid 
was, however, not employed in the plague of Lefchimo. 



CONCLUSION. 



I have thus given a detailed account of the plague in Lefchimo, 
which was attended with some circumstances of peculiar diffi- 
culty,* and which could only be encountered by the efficient 
measures which were adopted; and that these measures were 
completely successful, the health of Corfu from that time till 
the present moment sivfficiently shows. During my residence 
in the island for seven months after the general free pratique 
was declared, nothing like plague made its appearance, nor 
anything to interrupt the public tranquillity. Once, indeed, 
about a month after my return from the district, there was a re- 
port that the plague had re-appeared, and on that occasion, 
though suffering from a distressing complaint in my throat, and 
general bad health, I went down to ascertain what foundation 
there was for such a report. I found, however, on minute 
inquiry into the case, that there was no good reason whatever 
for spreading such a rumour. Having done this, I returned the 
same evening to Corfu, to make my report to General Smith, 
then the locum tenens of Sir Thomas Maitland. Before leaving 
the district, I warned the magistrates and people of the place 
to guard against the promulgation of such cruel and malicious 
reports, (for in the instance just mentioned, I had ascertained 

* I allude to the length of time that was lost before an effieient police was 
arranged, and the unhappy system of burning the people's houses. 

x 2 



296 



CONCLUSION. 



that the matter originated in some family quarrels,) observing 
to them, that if such were again spread abroad, the government 
would feel it indispensably necessary to take serious notice 
of it. 

The perfect state of the public health in Corfu, as far as 
regards plague, for so long a time from the date of its sup- 
pression there, forms a striking contrast with what has been 
going on along the shores of Barbary for the same period. 
There, no measures to prevent the extension of the calamity 
having been adopted, nor any means of expurgation used for 
future security, as far as my information reaches, the malady has 
continued for years to make sad ravages along that coast by 
the intercourse which naturally takes place among the people, 
careless and ignorant as they are of the benefit of quarantine. 
I have not lately heard of what may be going on there, but I 
take it for granted that the consuls residing in those places 
afford the necessary information to the government. Individual 
Franks may, from adopting measures of precaution, secure 
themselves, yet the general effective system which I have nar- 
rated is not adopted, as either not known, or, from prejudice 
and other causes, not carried into effect, nor believed to possess 
the advantages which I have proved it to have had in the 
plague of Lefchimo. Individual precautions will secure those 
who put such in full force ; yet they can go no further; but, in 
order that the system may have the proper effect, it must be 
general, not partial ; and the method which I have recom- 
mended should be carried on with the most scrupulous exact- 
ness in all its branches. The principle of prevention is simple, 
and easy to be understood ; it is nothing more than to avoid all 
contact with suspected persons or effects ; or, in other words, to 
shun every person or thing which we do not know to be posi- 
tively free from plague contagion ; whilst that of future security 
depends on the annihilation or purification of whatever is sup- 
posed to contain it. 



CONCLUSION. 



297 



The plague which for years raged along the Barbary shores 
first excited the public attention about the time that the malady 
broke out in Corfu, although most probably it existed before 
that time ; and its extension there, from place to place, is 
nothing uncommon, where no means to check its progress have 
been adopted; and this remarkable trait in its character has 
always been the same in all climates and countries wherever 
the malady has existed down to the present day ; whilst, on 
the other hand, we have seen, particularly on very recent occa- 
sions, that by proper management it can be forcibly prevented 
from extending itself, and finally perfectly extinguished, even 
under the most aggravated circumstances. 

Connected with the late plague duties of Corfu, there were 
several minor points to settle, which I finished on my return 
from the district of Lefchimo ; among which was the distribu- 
tion of the money which the government had granted as a com- 
pensation for the losses sustained by the individuals whose 
effects had been burnt when the depot was destroyed. Al- 
though, strictly speaking, my plague duties of every kind 
ceased on the issue of the last proclamation for general 
pratique, yet at the request of the President of the Senate, the 
Baron Theotoky, that I would thus finish the plague service, I 
immediately acceded to his wishes. 

In the plague of Lefchimo, the want of a general return of 
the casualties anterior to the 7th of March (for it appears that 
none had existed prior to that time,) prevents me from giving 
so accurate a statement of the admissions and deaths as I could 
wish. In the absence, therefore, of such document, (which on 
every account would have been most desirable, and the want of 
which gave me much trouble,) I called upon the medical gentle- 
men who had been in charge of the pest establishments for 
the most correct returns they were able to afford, specifying the 
age, the sex, and the eruptive appearances which the cases ex- 
hibited, the length of time the patients were ill, and such other 



298 



CONCLUSION. 



information as they were able to give me. From the villages 
themselves, also, I gained a pretty correct statement of the 
number of persons who had died of the calamity, as I have 
already noticed. 

Whatever returns or remarks were made by the late Mr. 
Tory, assistant-surgeon to the forces, or by Dr. Piccoli and his 
son, two native medical gentlemen, all of whom died early in 
the calamity, were either lost or destroyed ; at least, I could 
never gain any information respecting them. 

It was fortunate, however, that in the want of a general state- 
ment, the other medical gentlemen in charge of hospitals — viz., 
Mr. Sammut, Dr. De Georgio, and Mr. Saisset, had kept state- 
ments of the casualties in their respective hospitals, which in 
some degree made up for this deficiency. From Mr. Sammut, I 
received a nominal list of the ages, &c, of 147 patients belong- 
ing to the five impested villages of the Lower Lefchimo, who 
had been admitted into his hospital at St. Theodoro, of whom 
132 died, and 15 recovered. Of those who died, 89, it appears, 
belonged to St. Theodoro, and of those who recovered, only 7. 
This list comprehends the period from the 28th of January, 
when that hospital was first established there, till the 24th of 
March, when it was broken up, and the whole transferred to 
the camp-district. The following are abstracts from this return, 
showing the eruptions which the cases exhibited. It will be 
seen that the deaths here are nearly nine in ten, which is greatly 
at variance with Mr. Tully's statement in his book. 



Died. 



Class 1. Simple bubo in the groin 
„ 2. Bubo ditto with petechia 
„ 3. Ditto and in the axilla 
„ 4. Simple bubo in the axilla 



62 
9 
3 

16 
2 
3 
1 

11 



,, 5. Bubo in the axilla, with petechia 1 
„ 6. Bubo in the glands about the neck 



7. Ditto with petechia? 
„ 8. Simple carbuncles . 



CONCLUSION. 299 

Class 9. Carbuncles with petechia 1 

„ 10. Simple petechia 15 

„ 11. Anomalous cases 9 



Total . . .132 

Of the Class No. 1, seventeen had buboes in both groins, and 
two of Class No. 2. 

The following is a statement of the duration of the disease: — 

Died on or before the fifth day after admission into the hospital 104 

„ between the sixth and the ninth day 23 

„ on the tenth day 1 

„ on the fifteenth day 1 

„ on the twenty-fifth day 1 

„ on the twenty-eighth day 1 

„ on the fiftieth day 1 

Total ... 132 

The person who survived to the fiftieth day was a weakly 
girl, only ten years old, who had three buboes and two car- 
buncles, and who, after lingering for so long a period, sunk at 
last under the consequences of the disease. 

As to the fifteen who recovered, the following is a statement 
of the external appearances which accompanied their cases : — 



Simple bubo in the axilla , 2 

In the groin (one had one in each groin) 11 

Carbuncle 1 

Carbuncle with bubo in the groin . 1 



Total. ... 15 
On the 7th of March, the period at which the regular daily 
returns in my possession commence, it appears that the number 
then infected amounted to 77 ; and from that time till the 18th 
of May, when the last case of plague occurred, the admissions 
amounted to 146, making in all, 223. Of these, there died, 
till the 19th of May, the date of the last plague death, 136, 
leaving 87 recoveries from plague, wdrich accords with the 
number I have mentioned when speaking of encamping the 
convalescents, and. including the supposed cases of plague. 



300 



CONCLUSION. 



Dr. De Georgio furnished me with a nominal return of the 
ages, external eruptions, &c., of 167 patients who died in the 
hospital of Santa Trinita, to the charge of which he had been 
sent on the breaking out of the malady, and in that established 
afterwards in the camp-district under his care. This return 
embraces a period from the 13th January, 1816, to the 19th May 
following, and of course includes the 136 deaths mentioned 



above. 

The abstract from this return is as follows : — 

Died. 

Class 1. Simple buboes in one or both groins 59 

„ 2. Buboes in the groin, with petechias 5 

„ 3. Ditto with carbuncles . 1 

„ 4. Ditto ditto and petechias 2 

„ 5. Simple buboes in one or both axillae 22 

„ 6. Buboes in the axilla, with petechias 3 

„ 7. Ditto with carbuncles 1 

., 8. Ditto ditto and with petechias 3 

„ 9. Simple carbuncles 19 

„ 10. Carbuncles with buboes _ . . . 1 

„ 11. Ditto with petechias 5 

„ 12. Simple petechias 36 

„ 13. Ditto vibices 2 

„ 14. Buboes in the glands about the neck ...... 6 

„ 15. Petechias and carbuncles 1 

Total. . . .167 
The following is a statement of the duration of the disease : 

Died. 

On or before the fifth day 149 

From the fifth to the ninth 14 

On the tenth day (buboes in the axilla) 1 

On the eleventh (bubo of the parotid gland) 1 

On the twelfth day (bubo in the groin) . 1 

On the fifty-seventh day (bubo in the axilla, a child three 

years old 1 

Total ... 167 
It is to be observed that these calculations of the periods of 



disease are made from the day the patients were received into 
the hospitals, and not from the time they were first attacked by 



CONCLUSION. 



301 



the disease, which at the beginning could not well be ascer- 
tained, and before the proper arrangements were made ; and 
although the great mortality always takes place before the ex- 
piration of the fifth day, yet it is probable that in this instance 
the increased proportion took place from the difficulty in re- 
moving the sick to the hospitals, which were sometimes at a 
considerable distance, from the extreme badness of the roads, 
and the want of proper conveyances, or the means of carrying 
them. Indeed, it is agreed on all hands that no class of patients 
bear the fatigue of removal worse than the plague-patients. 
Yet this is no good reason either for multiplying pest estab- 
lishments or for permitting pest patients to remain in their 
houses longer than it can possibly be avoided. We are there- 
fore under the painful necessity, on account of the public safety, 
of removing plague-patients, — I had almost said, whatever the 
consequences may be to themselves, — and we cannot well 
draw a comparison between them and other classes of sick as 
to the quantum of injury they may experience by such removal, 
or consider the consequences which may arise ; the essential 
point being, for obvious reasons, to weed out the plague 
wherever it makes its appearance as quickly as possible, and 
place it in the pesthouse, where it should be. 

The following is a statement of the eruptive appearances of 
those who recovered : — 



Bubo in the groin (several having one in each groin) . . 40 

Ditto, with carbuncles in different parts 4 

Ditto in the axilla 10 

Ditto with carbuncles 2 

Carbuncles simply 9 

The doubtful or supposed cases of plague 7 

Convalescents sent from St. Theodoro (already noticed) . 15 

In all . . . . 87 



It ought to be observed, that of the number mentioned as 
infected on the 7th of March, a considerable proportion had 
passed through the violence of the disease in the different pes1 
establishments, and were in a fair way of recovery at that time, 



302 



CONCLUSION. 



but were kept on the strength of the returns as infected, as 
many of them required medical treatment. 

But besides those I have mentioned as recovered, I have 
reason to think that there were several others who got well and 
returned to their families. I had, however, no means of ascer- 
taining their precise number. Some of them were afterwards 
discovered by chance at the inspections of the villages. 

In some of these cases, too, from the accounts which these 
persons gave of themselves, the disease appeared to have been 
so slight that they required no medical assistance whatever, and 
were thereby enabled to conceal their indisposition in the early 
part of the calamity, before matters were properly arranged. 

In the examination of both the above returns, with reference 
to the ages of the persons admitted, I find them to be of all 
ages, from the state of infancy* on the mother's breast to the 
age of eighty, and above it ; but the greater mortality ayjpeared 
to be from the age of fifteen to thirty, (probably because they 
were the most numerous class ;) nor can I take upon me to say 
that the calamity was more fatal to man than to woman, the 
disease appearing, as I have already stated, to attack both 
sexes indiscriminately ; and all exposed to it seemed equally 
liable to suffer, without distinction, from its malignant and fatal 
character. 

From Mr. Saisset, who had had charge of the hospital of 
Clomo, I did not get the particular information which I required, 
as he had lost several of his papers containing various obser- 
vations and remarks. He furnished me, however, with a detail 

* Of such unfortunate infants, I have no doubt but some might have died 
from the want of maternal care, having been brought into the hospitals with 
their mothers, after whose death they had no one to look after them properly. 
I remember one of these poor little orphans, a girl about two years old, a very 
interesting infant, attached herself to one of the condamiati, who was also 
remarkably fond of her ; and he, as far as possible, supplied the place of her 
mother. After remaining in the hospital for several months in perfect health, 
she at length caught the disease, but got favourably through it, and was finally 
liberated with the rest. 



CONCLUSION. 



303 



of eleven of the most remarkable cases admitted into his hos- 
pital. The loss sustained in Clomo by the calamity I have 
already mentioned when speaking of the propagation of disease 
there. 

It is worthy of observation that, in examining these returns, 
I do not find that any one recovered who had either petechias 
or vibices ; and in the different conversations which I had with 
the medical gentlemen afterwards, they remarked to me that no 
one who had these symptoms had ever recovered, and that they 
therefore considered such, when they did occur, as the most 
fatal symptoms which accompany the malady. 

But although in the plague of Lefchimo the appearance of 
these eruptions invariably portended death, I am aware that 
some authors have recorded instances of recovery even from 
these appalling symptoms. Nevertheless, those writers who 
have done so, have, by universal consent, designated them as 
almost always fatal, and have informed us that the recoveries in 
such cases bear but a very small proportion indeed to the deaths. 

Although, for the reason assigned, I am unable to state with 
precision the number of plague deaths previous to the 7th of 
March, yet from all the information which I have been able to 
collect, they amounted in the different places, besides those 
noticed in the returns, to about 199. The number will there- 
fore stand as under : — 

In the pest establishments of Marathea and Rumanades, and 

in other places, chiefly in the upper district 199 

In the pest hospital of Santa Trinita, and in that established in 

the camp district 167 

In the village of Clomo and in the hospital there 46 

In the hospital of St. Theodoro 132 

In all . . . . 544* 

* This return may not be, strictly speaking, correct, but it comes as near 
the truth as possible. Of this number, twenty-five were soldiers belonging to 
British regiments. 

On referring to my statement of plague deaths forwarded to the medical 
board, I find it to have been considerably higher than the present one ; which 
last, on a more minute investigation, I consider to be nearer the truth. 



304 



CONCLUSION. 



It has been supposed, that during the prevalence of plague, 
other complaints are suspended, or, as it were, swallowed up 
by the all-devouring enemy, and that ordinary indisposition 
partakes of the character of plague. I cannot, however, adopt 
this opinion ; and certainly we did not find it so in Lefchimo, 
as we had a good deal of ordinary indisposition at the time the 
malady was starting up in the camps and in the villages ; and 
latterly we had not much difficulty in discriminating betwixt the 
one and the other. This, if it had been the case, I had the best 
means of ascertaining during my residence within the district, 
as there were intelligent medical officers, who examined daily 
all the inhabitants of the villages which had been attacked by 
plague, and reported to me not only all suspicious circumstances, 
but also all the cases of ordinary indisposition which at any 
time occurred. In the villages also which never had been 
attacked by the plague, and of course were not subjected to 
these medical inspections, the magistrates were directed to 
send word to me whenever any person was taken ill, whatever 
the complaint might be ; and such complaints as occurred were 
treated in the villages, and even in the camps themselves, ac- 
cording to the usual manner, (with the precaution of avoiding 
contact,) just as if no plague were existing in the district, and 
were eventually either cured or the patients died, without any 
suspicion of the plague hanging about them. 

I can easily imagine, however, what has given rise to this 
opinion, and I have no doubt that the fact is, that, during the 
alarm and consternation which take place in the time of plague, 
persons who may really have no plague about them, and who 
labour only under common complaints, or the depressing effect of 
fear, and no doubt are extremely unwell, become dreadfully 
apprehensive for themselves, and their indisposition is pro- 
nounced to be plague without being properly examined into. 
I do not conceive that apprehension alone would cause the pro- 
trusion of buboes or the other eruptions. But we know 
enough of the powerful effects of fear to cause universal de- 



CONCLUSION. 



305 



rangement of the system, and, in some instances, even death 
itself. Moreover, there can be no donbt that persons under 
these circumstances have been dragged to a pest-hospital, when 
they ought not to have been touched ; but from the equivocal 
nature of the symptoms on some occasions, (however much this 
is be lamented,) I do not see that it can be always avoided. 

From the memoranda which I kept of the deaths from common 
complaints, I find that both in the villages and in the camps 
they did not exceed ten from the time of my appointment till 
the 1 9th of May, when the plague entirely ceased ; about which 
time the usual epidemic fever made its appearance, which, how- 
ever, from what I could learn, was not so fatal as it had gene- 
rally been. Of those who died during the period mentioned, 
one was a weakly infant of three months, one a woman in child- 
bed, one a case of chronic dysentery, and seven old people, 
from the age of seventy-six to ninety-eight, who, as might be 
expected, were much debilitated, and, indeed, completely worn 
out. These, for a population of about 7000, were certainly 
but few ; which circumstance showed at least that the country 
was healthy as far as regarded other complaints. 

It has been seen in the narration which I have given, that 
about the time the plague ceased, the epidemic fever com- 
menced, and soon became general over the district, assuming 
the usual appearances, and quite unconnected with the general 
train of symptoms which more immediately characterise the 
true plague. 

Previous to my taking the charge of the district, and whilst 
the plague was raging, I had no means afforded me of ascertain- 
ing the state of the actual public health separate from plague. 
But I could not learn on inquiry that there had been any other 
sickness prevailing which excited attention, exclusive of that 
malady. 

In concluding this work, I am sensible that, in such a subject 
as this, there are occasional repetitions which I have found it 
difficult to avoid altogether, because I have been obliged to 



306 



CONCLUSION. 



consider the subject in different and sometimes in opposite points 
of view in the details and history, although not in the principle 
which has been acted upon, for that must be the same, from the 
time of Muratori (the only writer who has thoroughly understood 
the police of plague,) until the present time. He was the first who 
made a road for the management of this destructive and hitherto 
invincible enemy. The plan I have narrated may be capable of 
great improvement in detail, but I think the principle must be 
the same, wherever and whenever plague makes its appearance. 

In the account of the management, I have carefully avoided 
hypothesis, and have only stated facts as they occurred, or as 
they were brought before me. I had no previously formed 
opinion to advocate; and if I must be candid, I had really little 
matured opinion on the subject, except that it was a dreadful 
calamity; and I do not know, with my present experience on the 
subject, that I should all at once have thrown myself voluntarily, 
I may say, amongst my plague patients in Egypt without any 
help whatever. This, however, I did, and fortunately escaped ; 
but several others fell victims to it there. 



APPENDIX. 



I. CASES. 

CASES OF PLAGUE WHICH OCCURRED IN THE DISTRICT 
OF LEFCHIMO. 

Before entering on the detail of these cases, it is necessary I should 
observe that they were officially transmitted to me, as the super- 
intendent, by Messrs. Saisset, Grimellaro, and Dr. De Georgio, and 
were written in the French and Italian languages. They are selected 
from among many others as being the most interesting, and as show- 
ing the irregular and diversified symptoms with which this disease is 
so often accompanied. 

After what I have already said on the doctrine of contagion, and 
of the plague being contracted only by actual contact^ or, in other 
words, by communication with either impested persons or goods, I have 
nothing further to add with respect to these cases. They occurred 
at various periods during the prevalence of the calamity, and, beyond 
any doubt, were all owing to the same cause, although, in the time of 
plague, it is quite impossible to fix the proof in each particular case. 
Indeed, this is not to be expected, however desirable it might be to 
obtain this specific information. 

It is to be observed, that the examination of the bodies after death 
is entirely confined to external appearances; and I am not aware that 
at any period of the calamity, and certainly not during my superin- 
tendence, any bodies were dissected. Indeed, although an anatomical 
dissection might show the ravages of the disease, yet I question 
whether such discovery would bring us nearer the proper method of 
cure. At all events, the dissection of plague bodies is an operation 



308 



APPENDIX. 



so fraught with danger to those who might wish to perform it, that I 
would hesitate before giving my sanction to its being done, as I should 
consider it an act of great temerity, not called for. 

The following cases were transmitted to me by Mr. Saisset, and 
were originally written in French. Except the two British soldiers, 
all the persons mentioned were natives of Clomo. 

Case I. 

Jacometto Lavrano, aged 36, of a sanguineous temperament, was 
attacked on the 29th of December, 1815, about eight o'clock a.m., 
with slight symptoms of pyrexia and headach. At five p.m. of the 
same day, the fever increased, with violent vomiting. The headach 
increased, the tongue white, enlargement of the inguinal glands, 
attended with delirium. 

On the 30th, less fever, and delirium less violent; headach also 
diminished. I gave him the tartar emetic and the decoction of bark, 
with camphor. 

31st. The glandular enlargement has increased, and a bubo is formed 
of a very bad kind; that is to say, with the base of a livid colour, 
having the apex of a deep black. Applied a large blister to the bubo, 
which I allowed to remain till the day following. 

Jan. 1st. The patient complained of pain in the calf of the right 
leg. On looking at it, I discovered another pestilential bubo, to which 
I applied another blister, which was of great service. On removing 
the blisters, both the buboes were open, with an abundant suppuration. 

Jan. 3rd. The patient finds himself better. I gave him the bark 
and camphor for several days. The buboes continued to discharge, 
and by the 15th, they were healed. 

24th. The patient was again attacked with slight symptoms of 
fever, and complained of pain under the left clavicle. On examina- 
tion, I perceived another bubo like the former. I applied a blister, 
as before, and administered the tartar emetic. 

25th. Tongue cleaner, the headach gone, and the pyrexia 
diminished. 

26th. Having removed the blister, the bubo was open; but the dis- 
charge was trifling. 

27th. The patient complained of very severe pain between his 



APPENDIX. 



309 



shoulders. On examination, I found a tumour, to which I applied 
emollient poultices for a couple of days, and then opened it; when I 
discovered that it communicated with the other bubo, (and was, in 
fact, a fistulous sore,) I injected a decoction of bark into the sores, 
and applied compresses. 

29th, 30th, and 31st. The patient goes on favourably. 

Feb. 1st. He complains of pain and inflammation in his eyes, for 
which I continued the proper treatment till the 21st, when he was 
cured.* 

Case II. 

Costantino Lavranno, 15 years old, of a sanguineous temperament, 
on the 29th of December had severe symptoms of fever, with violent 
headach. I ordered him the tartar emetic, which produced full 
vomiting. 

30th. The pyrexia and headach less severe. 

31st. He complained of pain in his groins; and on examination, I 
discovered two inflamed tumours of a bright red colour, shining, and 
extremely painful. 

Jan. 1st. The tumours are increased in volume, and accompanied 
with black pustules, (des pustules noires.f) 

2nd. The base of these tumours had become surrounded with an 
inflamed circle, having a dark, shining appearance. 

3rd. I opened the tumours, from which only a small quantity of 
blackish matter was discharged. Febrile symptoms very high, and 
the patient extremely ill. 

4th. Suppuration has come on. 

5th. Less fever. 

6th and 7th. I purged him with rhubarb. 

8th and 9th. He finds himself a little better. I ordered him the 
bark and camphor till the 16th. 

17th. He is considerably better. I continued to dress his sores 
with the ])ulv. cinchonce till the 27th, when I considered him cured. 

* Some months afterwards, I saw this man in Clomo. There appeared to have 
been very severe inflammation in both eyes, which in one of them finally terminated 
in ulceration of the cornea, with almost total loss of vision of that eye. The 
vision of the other eye was also impaired. 

f I am inclined to think that these pustules noires were not real petechia?. 

y 



310 



APPENDIX. 



Case III. 

Jan. 1st. Papa Postoli Lavranno, aged 30, of a bilious tempera- 
ment, was severely attacked with fever, violent headach, and continual 
vomiting. 

2nd. Fever increased, as also the pain in the head. His eyes 
troubled, (les yeux troubles,) tongue very white, much delirium. 
Ordered him the tartar emetic; which, however, was productive of 
no benefit. 

3rd. Complained of very acute pain in the inguinal glands, and in 
those of the throat. On examination, I found pestilential buboes in 
both places, and the rest of his body full of petechias. 

4th. I applied blisters to the buboes, and gave him the decoction of 
cinchona, with camphor; but he was getting decidedly worse. 

On the 5th, at five o'clock in the morning, I found him dead; and 
on examining the body, I found the buboes ashy-coloured, with small 
carbuncles over the body, and the mouth filled with black, filthy sordes. 

Case IV. 

Jan. 1st. Stamati Lavranno, of a bilious temperament, (the age 
not mentioned,) complained of violent headach, with continual 
vomiting. Gave him a dose of rhubarb. 

2nd. He had a very severe paroxysm of fever; headach increased. 

3rd. Complained of pain in the inguinal and parotid glands; and 
on examination, I found two buboes in the parotid glands, and a very 
considerable enlargement in those of the groins. 

4th. The fever has much increased; tongue white. The eyes have 
a wild appearance; and he has continual delirium. I applied blisters 
to the buboes, and administered the bark and camphor; but he is 
getting worse. 

5th. Petechias have appeared. 

6th and 7th. Seems to be perfectly insensible, and continually 
delirious. 

8th. At 8 o'clock a. m., I found him dead ; and on examining the 
body, I observed it covered with petechias, and the buboes of a dark 
livid colour. 



APPENDIX. 



311 



Case V. 

Jan. 1st. Spiro Lavrano, aged 70, of a sanguineous temperament, 
complained of acute pain in both groins. I examined him, and discovered 
two large buboes. He assured me that for the last three days he had 
felt pain in his groins; but that they were not sensibly enlarged till 
to-day, when I saw him. He had little or no fever, and his head was 
clear. 

3rd. Pyrexia has come on. Tongue very white, with violent 
headach. I gave him the tartar emetic, and applied blisters to the 
buboes. 

4th. Pyrexia considerably increased, and the headach is now become 
insupportable. His eyes wild, with continual delirium. 

5th. About the middle of the thigh, several small carbuncles have 
made their appearance, to which I applied the actual cautery {baton 
defer?) 

6th. Eemoved the blisters, and opened the buboes. 
7th. Less pyrexia, but the headach continues. 

8th. Ordered him a dose of rhubarb, which had full effect; I or- 
dered him the bark with assafoetida, and dressed the sores with a 
decoction of the former. By the 24th, he was perfectly cured. 

Case VI. 

January 4th, 3 p.m., Spiro Aftimo, aged 41, of a bilious tempera- 
ment, complained of acute pain in the groins, and of insupportable 
heat all over his body. On examination, I discovered a very consider- 
able enlargement of these glands, and the body full of petechia and 
carbuncles. 

5th. Pyrexia much increased, and headach extremely violent, with 
continual delirium. 

6th. At 7 a.m. I found him dead. On examining the body, I dis- 
covered the glandular enlargements of a livid colour, the petechias 
purple, and the carbuncles quite black. 

Case VII. 

January 4th. Janni Lavrano, a child two years old, at 10 a.m., was 
attacked with slight symptoms of fever, with enlargement of the in- 

Y 2 



312 



APPENDIX. 



guinal and parotid glands. About noon, the fever was considerably- 
increased, and the glandular enlargement of a purple colour. Petechias 
appeared, and by five in the afternoon he was dead. 

This child's father had already died of the plague. His mother was 
ill at the time, and had buboes in the groins and parotid glands. She 
died the day after her son. 

Case VIII. 

January 20th, 10 a.m., Ursula Lavrano, aged 48, of a bilious tem- 
perament, had a severe attack of fever, with violent headach. To- 
wards noon, a bubo made its appearance on the fore-arm, with petechias 
all over her body. 

21st. Pyrexia increased; the tongue dry, and she complains of con- 
tinual thirst. 

22nd. The febrile symptoms still more violent, and the headach in- 
supportable. The eyes wild with furious delirium. 

23rd. The febrile symptoms still further increased. The tumour of 
a black colour. The petechias spots purple, and the whole skin red 
and inflamed. 

24th. In her increased delirium during the night, she escaped from 
the hospital, and ran about till 6 o'clock in the morning; when I got 
her brought back to the hospital, and two hours after her return, she 
expired. The body exhibited the usual appearances, with small blackish 
carbuncles on different parts. 

Case IX. 

Jan. 18th, George Jany, soldier of De Rolle's regiment, of a bilious 
temperament, (age not mentioned,) was attacked severely with fever, 
headach, and delirium. 

19th. I observed a large bubo in the parotid gland; tongue white; 
eyes wild. I ordered him the tartar emetic, and afterwards gave him 
the decoction of bark. 

20th. Petechias and small carbuncles have made their appearance. 

21st. The patient seemed to be a little better. I made him take the 
bark with camphor, but without any benefit. 

22nd. Fever increased, accompanied with furious delirium; the 



APPENDIX. 313 

bubo became blackish, the petechias purple, and the carbuncles quite 
black. 

23rd. At 6 o'clock in the morning I found him dead. 

Case X. 

Jan. 20th, Joseph Golder, soldier of De Rolle's regiment, of a san- 
guineous temperament, (age not mentioned,*) complained of pain in 
his head, and of a swelling about the middle of his thigh. On examina- 
tion, I found a large tumour there, and a number of small carbuncles 
dispersed all over his body. I immediately gave him the tartar emetic, 
and afterwards the bark. 

21st. Applied a blister to the tumour. 

22nd. He appeared to be a little better. Having opened the 
tumour, or bubo, there was a considerable discharge of matter from it. 

23rd. Applied the actual cautery {baton de fer) to the carbuncles. 

24th. The fever and headach have increased, and he complains of 
being very ill. 

25th. The bubo and the carbuncles have become gangrenous. 

26th. Less fever. I ordered him the bark with camphor. 

27th. A large eschar of about six inches in breadth by eight in 
length, separated from the bubo; I dressed the sore with the bark, 
and gave him the bark and camphor internally till the 21st of Feb- 
ruary, the period at which my hospital was broken up, and transferred 
to that of Santa Trinita, near the village of Argirades.f 

Case XI. 

Jan. 26th. The Papa Janni Babi, aged 36, of a bilious temperament, 
about 12 o'clock at night, was seized with vomiting and cold rigors. 
Two hours afterwards, these went off, and were succeeded by a hot fit. 
This morning, about 3 o'clock, I saw him, and administered the 
tartar emetic, but no vomiting was produced; by 4 o'clock, he had 
three stools; at 5, the fever returned, and he complained of pain 
in the glands of the groin. On examining the parts, I discovered 

* I frequently saw this poor man afterwards, and think he may have heen about 
thirty or thirty-five years of age. 

f The sequel of this poor man's case has been already mentioned. 



314 



APPENDIX. 



pestilential buboes, and the skin covered with petechias; at 8 
o'clock, I applied the blisters to the buboes; about noon, the febrile 
symptoms had a little diminished; I ordered him the bark with 
camphor and asafoetida. Afterwards stupor came on. 

28th. About 5 o'clock this morning, the febrile symptoms and 
headachhave increased, with the addition of delirium; the buboes are 
blackish, the petechia? purple, and the whole skin red and inflamed. 

29th. The delirium having ceased, he became weak, and lost the 
power of speech, {jperdit ses forces, et la parole,) and was motionless, 
but with his eyes wild and his visage pale. 

30tb. At 10 in the forenoon, I found him dead. 

This clergyman had caught the disease by taking some effects be- 
longing to a man who had been attacked by the plague more than 
twenty days before, and who was convalescent at the time. I lodged 
with him till his last moments. (J'ai ete loge chez lui jusqu'a ses 
dernier s momens.)* 

The following cases were transmitted to me by Assistant- Surgeon 
Gemellaro. Some of them were his own immediate patients early in 
the calamity; the others he had occasion to see afterwards, during the 
prevalence of the malady, from his proximity to the hospital in the 
camp district, where he was afterwards stationed, and from daily, and 
indeed, almost hourly conversations with Dr. De G-eorgio, (who was 
immediately in charge of the hospital,) or the cases which were ad- 
mitted into it; and which, from his situation there, he had occasional- 
most always to see before they were admitted into the hospital. Mr. 
Gemillaro was a young man of considerable professional acquirements, 

* The circumstance of Mr. Saisset's residing in the same house with this clergy- 
man will account for the early hours at which he saw him. 

Most of the patients mentioned above hear the surname of Lavrano, hut the 
reader is not on that account to infer that they all belonged to the same family. 
This is not the fact ; they belonged to several families of the same name ; and I 
believe I am correct in stating that, in some of the villages of Lefchimo, not less 
than one-half of the inhabitants are of the same surname; and Lavrano is the 
general family name in Clomo. Other villages have other family names. I did 
not inquire much into the reason of (here being so many families named alike in 
the same place ; but from what I could learn, it appeared to me that it was owing 
to something of a clannish nature. At any rate, the fact is as I have stated it. 



APPENDIX. 



315 



and he regularly recorded those cases at the time. I have no reason 
to doubt the accuracy of what he details. 
The cases were written originally in Italian. 

Case XII. 

Jan. 7th. Mr. Tory, Hospital- Assistant, aged 23. This young gen- 
tleman, who was in charge of the pest patients in the camp of Mara- 
thea, after his return last evening, from visiting the impested villages, 
was to all appearance in perfect health, and after having ate a hearty 
supper in the house of the Signor Nicolo Trivoli, with whom he was 
staying at the time, was attacked with fever in an excessively violent 
manner, (viene assalito dalla febre, con una violenza eccessiva,) which 
threw him into a state of great agitation and dread. He refused to be 
bled, as he had already found that mode of practice to be unsuccessful 
where he had tried it; in place of which he caused a blister to be 
applied to the nape of his neck. 

When Mr. Tully and I went to see him, Dr. De Georgio, who 
attended him at the time, informed us that he already complained of 
an acute pain in the groin. Mr. Tully, with every necessary pre- 
caution, went to see him in his room, and to endeavour to keep up his 
spirits, strongly recommending him to be bled ; which he, however, 
positively refused to allow. His head was confused, and his general 
appearance very considerably changed; his eyes were stern and 
furious; he immediately got eight grains of calomel. A sinapism was 
applied to the groin for a couple of hours, and afterwards a blister. 

In the evening, stupor came on, during which he had two involun- 
tary evacuations. Two blisters were applied to his legs, and two 
common enemas were administered. 

8th. This morning, he became convulsed, and continued in a state of 
syncope for some minutes; after which he took the following draught: 

IjL iEther Sulph. ^i. Tinct. opii gtt. xv. Aq. menthse ^i. 
He felt himself very weak, and his head much confused. 

Towards evening, he was a little more composed ; took some broth 
and wine, and also a camphor mixture. The bubo continues painful, 
but does not seem to be enlarged, nor to protrude towards the surface, 
(ne tendere verso la cute. ) 



316 



APPENDIX. 



9th. This morning, he appears a little more calm, has taken some 
wine and broth, but has a great dislike to the camphor mixture. He 
asked me whether I thought his disease was the plague. The bubo is 
extremely painful, but has not increased in size ; his head is very 
giddy ; gave him the decoction of bark, and some of the best wine I 
could procure. 

10th. The stupor has returned this morning, and he does not answer 
distinctly to the questions put to him. Refuses all medicine and 
nourishment. Towards night, the stupor changed to a state of furious 
delirium. He got up from his bed, quite unconscious of what he was 
doing ; but in a moment afterwards he became exhausted, and fell on 
the floor ; his visage fierce and extremely changed and pale ; his lips 
livid, and his eyes of a turbid appearance. 

11th. To-day is become excessively languid, and neither speaks nor 
moves. In the evening, he vomited a great quantity of sordes, like 
grumous blood, extremely offensive to the smell, and in a few moments 
after, he expired. 

Case XIII. 

Jan. 23rd. Papa Lessi, or Alessi, of Cuspades, aged 38. This morn- 
ing was attacked with an obstinate epistaxis, accompanied with very 
great prostration of strength. No one could say whether or not he 
had had any febrile symptoms last evening. His countenance was 
pale and attenuated, and he was so weak that he could scarcely speak. 
The blood discharged was dark coloured, and like venous; he was 
ordered a mixture with vitriolic acid, which for a short time seemed 
to stop the haemorrhage. 

24th. Last evening, the epistaxis returned, and was so profuse that 
he fell into a state of deliquium animi, and never afterwards opened 
his eyes. The tide of life seemed to ebb away gradually, and in a few 
hours he expired. 

The body exhibited no other appearance of plague than a remark- 
able degree of flexibility. 

Case XIV. 

Jan. 26th. Spiro Lessi, son of the Papa Lessi above mentioned, aged 
10. This boy was so afflicted at the death of his father, that he 
refused all food, and only wished to remain quiet. His countenance 



APPENDIX. 



317 



became pallid, and he was so much debilitated, that he could scarcely 
stand in an erect posture for any length of time. 

He passed the whole of yesterday in bed, and had a degree of stupor. 
In the evening afterwards, he had a short fit of anxiety. He vomited 
a quantity of blood, shortly after which, a profuse epistaxis came on, 
and he immediately expired. The body did not exhibit any particular 
marks of plague. 

On these cases, Mr. Gimellaro remarks — " The death of this boy, 
with symptoms so very similar to those of which his father died, although 
none of the usual appearances of plague were observed after death, 
caused us nevertheless to suspect much that the disease by which both 
were carried off so very suddenly was by no means an innocent disease. 
I was the more confirmed in this opinion, when I learned that the 
papa two days before his death had been at the village of Rumanades, 
where the plague was at that time raging, to see if his house there was 
burnt, as had been stated to him.* In consequence, therefore, of 
these sudden deaths, the family and house of a man named Zervo, in 
which the boy had died, were, without loss of time, placed in qua- 
rantine.'^ 

Case XV. 

Feb. 11th. Maria Zervo, aged 26, belonging to Cuspades. For ten 
days after the death of the boy Lessi, (who, as we have seen, died in 
Zervo's house,) nothing of a suspicious nature having been observed 
in that family, who, to all appearance, were in perfect health, the 
quarantine restraint was removed yesterday morning, when, to my 

* It appears also that the papa's brother from Rumanades had died of the plague 
in his (the papa's) house, and I am more disposed to think that the family became 
impested from him, than from the circumstance of his having gone to Rumanades 
to look after his house there. 

| It is to be observed that these cases happened early in the calamity, when the 
disease was not so well known as it was afterwards ; and it would appear that the 
papa was not supposed, from the absence of the usual plague appearances, to have 
died of that malady, and that no precautions whatever were taken with respect to 
him. But when the boy was taken ill so soon after him, in the same way, and 
died still more suddenly than his father, Mr. Gimellaro began to be alarmed, and 
it was judged necessary to adopt some precautions in this case; which, however, 
do not seem to have been carried quite far enough. For my own part, I have no 
doubt but that both were very bad cases of plague, and no mode of treatment 
which we know could, in my opinion, have saved the patients. 



318 



APPENDIX. 



great surprise, I learned this morning that Maria Zervo, the mother 
of the family, then in the sixth month of her pregnancy, had had a 
fausse accouchement, without any one previous bad symptom, except 
great debility, and a few minutes after her delivery she expired. I 
went to see the body, but could perceive no other appearance than 
that it was more flexible than is usually seen. But from this day I 
began to doubt that the appearance of the body after death shows 
decidedly that the person died of plague. (His own words are — " Ma 
da questo giorno commincio adubitane die le apparenze del corpo dopo 
la morte passano mostrar decisivemente de la persona era attacata da 
peste."*) 

Case XVI. 

Feb. 24th. Stellia Zervo, aged 45, from Cuspades. This woman, 
who belonged to the same family, which was now considered impested, 
was this morning attacked with slight symptoms of fever, which were 
preceded by cold shiverings. Her countenance is changed, her 
mouth dry, her lips livid, and her tongue ashy coloured ; her head 
giddy. She complains of weight and oppression at her heart, which 
causes her to sigh heavily every moment, and of most acute pain in 
her groin. I sent her immediately to the hospital. 

Emplast. lytt. buboni per horas tres, et applicetur deinde cataplasma. 
£>. Calomel, gr. vi. Statim sumenda. 

2oth. During the night, she had two evacuations. The bubo is 
increasing, and looks as if it would come to suppuration. Cont. catapl. 
She is extremely pulled down, and without the least appetite for any- 
thing. Tongue still foul and dark ; pulse extremely small, but regular. 

R. Pulv. cinchon. ^ i. 
Camphor, gr. xx. 
Solv. in spt. vin. gtt. xxx. 
Aqua lo. iss. 

Sumat ^ ii. tertia quaque hora. 
She is ordered soup, and whatever nourishment she can take, as also 
a pint of wine. 

* Here Mr. Gimellaro doubtless means that persons may die of plague w ithout 
having those eruptive appearances after death -which are generally considered to 
characterise this malady. When they do occur, the matter is put beyond all doubt ; 
but their absence is not always a proper criterion to judge negatively. 



APPENDIX. 



319 



26th. The bubo is opened and dressed with the balsam d'Arceo. 
She feels very weak. Cont. ut heri. 

March 15th. After so many days, during which she continued pro- 
gressively to get better, she now finds herself pretty strong ; has a good 
appetite, and the bubo is almost cicatrized. 

20th. Cured. 

Case XVII. 

Feb. 26th. Crisulla Monasteriotti, 3 years old (from the highly sus- 
pected camp), belonging to St. Theodoro. Last evening, had a slight 
attack of fever, and this morning is extremely weak. Pallid coun- 
tenance, eyes fixed, tongue foul, and is so giddy that she cannot stand 
in an erect posture. Has vomited a quantity of greenish matter, after 
which she became comatose. Was sent to the hospital, where she 
immediately took 5 grains of calomel and 10 of rhubarb. 

27th. Purgative has operated twice. She refuses all medicine and 
nourishment of every kind. Is extremely reduced, and cannot keep 
her eyes open even for an instant. 

28th. Last evening she died. Her body did not exhibit livid spots, 
nor petechia;, nor tumours, nor any other remarkable appearances of 
the plague. 

Case XVIII. 

March 3rd. Maria Plascovitis, aged 12, of Argirades. Last night 
was attacked with most violent febrile symptoms, ushered in with cold 
rigors, which lasted for more than two hours; and this morning, when 
she awoke, she found herself all bathed in sweat. She was very 
languid when I saw her, but she got upon her feet, and told me that 
now she felt herself well, and that she believed her fever last night to 
have been occasioned by getting cold in the night under the tent, as 
she had never been accustomed to sleep in that manner before. Her 
tongue, however, was of the usual ashy whitish colour, and I observed 
a small red spot near the external angle of the right eye. She was 
sent to the hospital. 

Having arrived at the hospital, which at that time was nearly four 
miles distant, and the road exceedingly bad, she became very weak; 



320 



APPENDIX. 



and by this time, the red spot had assumed the appearance of a car- 
buncle. 

R Calomel gr. vi. Statim sumend. Some digestive was applied to the carbuncle. 

4th. Passed a tolerable night, and had two evacuations. This 
morning, she seemed to be much pulled down, but her head was clear. 
Takes bark and wine. The eschar of the carbuncle is black and hard, 
like a piece of leather; and about the edges it is highly inflamed. Cont. 

5th. During the night, she fell into a state of extreme weakness. 
This morning, the carbuncle was sphacelated. The body was 
covered with petechia?. Shortly after, she expired. The body was 
very flexible. 

Case XIX. 

March 3rd. Theodorella Vlassi, of Critica, aged 22. This young 
woman was yesterday admitted into camp, with all her family, in 
consequence of one of her sisters having died of the plague. 

On my visit this morning early, she seemed to be very well; but 
towards 8 o'clock a. m., as if struck with lightning, (colpita come del 
fulmine,) she fell into a state of extreme weakness, which at length 
ended in oppression about the prcecordia. I called on her to come 
forth from the tent, that I might see her, but she was unable without 
help to raise herself up. The staggering was so great that she was 
forced to lay hold of the pole of the tent to support herself, and to 
shut her eyes. (/ capogiri erano si violently che I obligavano a tenersi 
la ponte colla mano, e serrare gli occhi.) The tongue had the usual 
white appearance. Her lovely countenance (la di lei bella fisonomid) 
was not much altered. Her body was full of petechias, and whilst I 
was sensibly affected at the sight of her, foreseeing, as I did, the 
miserable end of this unfortunate creature, she conjured me to let her 
remain quiet for a few hours, after which she hoped she should be 
better. She, however, soon changed for the worse, and the hand of 
death lay heavy on her. She complained in the most distressing 
manner of pain about the prcecordia, which, she said, tormented her. 
But what distressed her above all was the sad sight of her relations, 
all hastening to clear the tent of their effects, and to remove them- 
selves to a distance from her. Her strength being now entirely 
exhausted, she expired at half -past 9 o'clock, only an hour and a-half 
from the moment she first began to complain. 



APPENDIX. 



321 



The body was full of petechias, livid, soft, and extremely flexible. 
This was the most violent case of plague I ever witnessed. 

Case XX. 

May 28th. Cicca Curri, two years old, from St. Theodoro. This 
poor female infant, having no one to take care of her, was taken to the 
hospital along with her mother and aunt, both of whom were attacked 
by the plague on the 5th of May, 1816, and both died of that malady. 

In the very bed where these died, and lying in their very arms 
when they were dying, this little innocent withstood the influence of 
the contagion, and defied its attacks. She was by this time seen like a 
little Nemesis in the hospital, constantly carried about in the arms of 
all indiscriminately, of the infected and convalescent, still enjoying 
the most perfect health. One of the forzati, or felons, who had be- 
come uncommonly fond of her, and had latterly taken upon himself 
the entire charge of her, was attacked with the plague. The un- 
fortunate infant who slept in the same bed with him, and who had 
two watery pimples on the left leg, became attacked with fever, ac- 
companied with an enlargement of the inguinal gland, and a carbuncle. 
In five days the former was discussed, and the latter got soon well. 
She now enjoys perfect health. 

Case XXI. 

March 6th. Tassia Plascovitis, aged 36, from Argirades, (was 
attacked in camp.) She was this morning attacked with unequivocal 
symptoms of plague, and sent to the hospital. Tongue whitish, eyes 
troubled and wild, complexion livid. She brought with her to the 
hospital an infant named Annetta, two years old, still at the breast. 

On her arrival in the hospital, she would neither take nourishment 
nor medicine of any kind, but drank a little wine, and became delirious 
during the night. 

7th. To-day the delirium has increased, and when any questions 
are put to her, she answers in a mad, furious manner, but her strength 
is so exceedingly reduced, that she is unable to stand in an erect 
posture. She refuses to suckle her child, who will not taste any kind 
of food. 

8th. A little after midnight, delirium increased to so violent a 



322 



APPENDIX. 



degree, that she jumped out of bed, seized hold of her infant, who was 
crying, and, horrible to relate, before any one could prevent it, with 
all the fury of a tigress, dashed it on the ground and killed it on the 
spot. The unhappy woman did not, however, survive long this dread- 
ful act, but in a state of perfect exhaustion, she shortly after breathed 
her last. 

Her body was full of petechias, and very flexible. That of the child 
had no appearance whatever of plague in it. 

Case XXII. 

March 7th. Anastasi Cavadia, aged 36, of Argirades, (was attacked 
in the camp.) This morning he was sent to the hospital, with bubo in 
the axilla, but with little or no febrile symptoms; he feels himself 
otherwise strong, and in perfect health; the pain in the axilla was, 
nevertheless, very intense. 

Sumat statim calomel, gr. vi. 
Applicetur emplast. lytt. buboni per horas quatuor, deinde cataplasm, emoll. 

8th. The pain in the axilla has lessened; has had a little accession 
of fever, but without cold shivering; had three stools; appetite gone, 
and he appears weak; ordered wine and the mist, cinchonas, so as to 
take 3 ij of the powder every two hours. 

9th. The tumour in the axilla appears to be diminishing in size, and 
the part to which the blister was applied is still a little inflamed; he is 
very weak. 

Repet. pulv. cinchon. et vinum. Capiat camphorse gr. vi. ter in die. 

10th. The tumour continues to diminish sensibly, and he is getting 
better. 

18. Tumour entirely gone, and he is in a state of convalescence. 
Case XXIII. 

March 18th. Stefani Monasteriotti, aged 20, from St. Theodoro, 
(occurred in the camp.) This morning, when he got up for the usual 
inspection, he told me he had a most violent toothach; he had slight 
epistaxis and sneezing; on observing which, I judged it proper to 
place him in a tent by himself. 

1% Pulv. antimon. gr. ij. secund. quaq. hora ad quartum vicem. 



APPENDIX. 



323 



He perspired during the night, but the side of his face where 
he had complained of the toothach, was already much swollen, and 
his tongue very white. 

19th. This morning he has evidently a bubo in the maxillary 
gland, and on the other side of his face something like a small boil 
appeared; he is very weak, and attacked with violent staggering, 
(assalito di violenti capogiri.) 

I sent him to the hospital, which was distant not more than two 
hundred yards, and on his arrival there, he seemed to be extremely 
exhausted; indeed, so much so, that he was unable to swallow either 
food or medicine; he became lethargic, and soon after fell into a com- 
plete state of stupor. 

20th. He expired this morning. 

A few petechias were observed on the body, which was of a livid 
colour in some places, but it did not appear to be flexible. 

Case XXIV. 

March 12th. Erasmo Micruli, aged 25, from Anaplades, (occurred 
in camp.) This morning, at my visit, he told me that he wished to 
go to the hospital, for that since last evening a bubo had appeared in 
his groin, and he had been attacked with fever and cold rigors, which 
were very severe. I saw the bubo; the skin over it was inflamed; 
his strength was but little impaired, and the appearance of his 
countenance was not altered. He was sent to the hospital. 

Sumat statim magnes. sulphat ^i. 
Applicetur emplast. lytt. buboni et cataplasm, emolliens postea. 

13th. Last night, he had a most violent return of fever, accompanied 
with furious delirium, in consequence of which the servants were 
obliged to tie him to his bed hand and foot. 

The bubo seems to proceed to suppuration. Cont. cataplasm. 

14th. The delirium continues, but the other febrile symptoms are 
much more moderate; he refuses food and medicines. 

The bubo is almost ready to be opened. Cont. cataplasm. 

15th. He was loosened for a short time this morning, as he was 
thought to be a little more tranquil; but no sooner was he freed, than 
he became more furious than ever. Took a little broth, and in the 



324 



APPENDIX. 



evening the bubo was opened with a lancet, when a great quantity of 
bloody matter was discharged. Cont. cataplasm. 

16th. He slept well last night, but for fear lest the delirium should 
return again, it was thought proper to keep him tied for four days 
longer. The bubo was dressed with the balsam d' Arceo. Takes bark 
and wine. 

30th. Gaining strength by degrees. 

April 5th. Convalescent. 

Case XXV. 

April 7th. Maria Crisicopulo, aged 19, from Anaplades. She was 
sent to the camp of observation last evening from the village on sus- 
picion of plague. 

This morning she was seized with symptoms of fever, cold rigors 
and headach; after which she fell into a profuse sweat. Tongue clean, 
countenance scarcely altered; has a small red spot on her back. Not 
having any of the remarkable symptoms, I of course would not send 
her to the hospital, but kept her in observation awaiting the result; 
and, in the meantime, gave her a gentle purgative, she being at the 
time pregnant four months. 

8th. This morning she appears to be a little better; tongue still 
clean and without anything remarkable in her appearance; the spot on 
her back is nearly gone, and her strength but little impaired. At the 
same hour as yesterday the fever returned, with cold shivering, and 
with every appearance of its being an intermittent fever; I ordered 
an ounce of the pulv. cinchonas to be taken during the night. 

9th. The spot has this morning assumed the appearance of a small 
carbuncle; tongue still clean, but her strength is extremely reduced. 
She has evidently a small bubo in the axilla; she went to the hospital, 
which was close by; a few minutes after her arrival, an uterine haemo- 
rrhage came on, and she immediately expired. 

The body flexible, petechias, &c. 

Case XXVI. 

May 16th. Anastasi Calojexopulo, aged 65, of Anaplades. This 
man with his family, consisting of four individuals, were sent from 
Anaplades to the highly suspected camp on the 6th of May, in con- 



APPENDIX. 



325 



sequence of one of his daughters being attacked with the plague, who 
died of it after a few days' illness. 

The family, on their removal to the camp, carried their susceptible 
effects along with them, and everything thus brought was frequently 
washed in the sea by himself and his family, and afterwards dried in 
the sun. Notwithstanding all this, on the 8th, two days after, another 
daughter, named Diamondulla, 1 5 years old, was also attacked and sent 
to the hospital, where she died the third day. 

This poor man, anxious for his own safety, and wishing to get rid 
of the plague contagion, still continued to wash and air his clothes and 
other effects, and to bathe himself in the sea. But this morning, ten 
days after his arrival in the camp, he complains of his head feeling 
heavy and giddy, of oppression at his stomach, and a bitter taste in 
his mouth. 

He was immediately separated from the other two remaining indi- 
viduals of his family, who had hitherto been lodged in the same tent 
with him, and placed in a tent by himself, to see how the case would 
terminate, and in the meantime was ordered a purge. In the evening, 
he felt a little lighter. 

17th. This morning he feels himself much better; his tongue is 
cleaner, and his head more free, (la testa piu libera;) and as he has 
had only two evacuations from the purgative, he was ordered half an 
ounce of the cream of tartar.* 

18th. This morning, his countenance indicates the progress which 
the disease had made in his system, (pggi la sua jisonomia indica il 
progresso preso dal morbo sopra il suo sistema.) His eyes are fixed 
and wild, his countenance pallid, he has staggering, is faltering in his 
speech, and his voice is hoarse and hollow; a bubo is already evident 
in his right groin; he is, notwithstanding, clear in his intellect, and 
was capable even of writing his last will. He was sent to the hospital. 

19th. This morning, on inquiry after him, I found he had died a 
little after midnight. 

* Mr. Gimellaro, when he sent in his evening report to me at Egrippos, 
mentioned this case, and his apprehension that it might eventually turn out to 
he a plague case. Early next morning, I went down to the camp to see the 
man. The case is already alluded to in the work. The other two of the family 
escaped. 

z 



326 



APPENDIX. 



His body was covered with petechia.* 

This case made a strong impression on my mind; and certainly I 
was in hopes that after a lapse of ten days, during which the remain- 
ing members of the family continued to all appearances in good health, 
and as they had been particularly careful in washing and airing their 
effects, and in bathing themselves in the sea, we should have had no 
more plague in that family. 

It was no doubt quite possible that he himself might have had the 
plague in his constitution before leaving his own house; or that he might 
have contracted it from his second daughter, Diamondulla, after his 
arrival in the camp. But it was also possible that he might have 
contracted the malady from airing and handling his impested goods. 

This case, therefore, and some others, suggested to me afterwards, 
that in order immediately to destroy any contagious matter which 
might remain in the effects which the people bring with them, it 
would be well to put them in hot water, as I have already noticed in 
another part of this work. I know this would be a troublesome 
operation, but in the treatment of plague we are neither to consider 

* I subjoin here the conclusion of Mr. Gimellaro's report in his own words, 
which, as a short summary of the symptoms and character of plague, may not be 
unacceptable to the reader : — 

" Questi pochi casi bastano per dare un' idea dell' anomolia della peste ; che none 
che il complesso di tanti sintomi gravissimi, la di cui comparsa non e mai regulare. 

" La descrizione, che io posso dare in generale della peste dopo tante osservazione 
si e, che ogni persona di qualunque sesso, ed eta, in qualunque stagione, che viene 
attacato dalla peste, lo dimostra all' alterata fisonomia ; il colorito, editratti del suo 
aspetto disengon mutati e strani ; i suoi sguardi sono concentrati e fieri ; ma molto 
piu spesso fissi; e gli occhi sono aseiutti ed opachi ; la testa si fa pesante e vertigi- 
nosa ; e l'infermo diviene tedioso ed irritabile, a non responde che a forza, con 
nojia e dispetto. Le segrezione sono disordinatissime. La febbre, che per lo piu 
apre la scena, spesso si manifesta con tutto il furore infiammatorio, col delirio, la 
frenesi, il furore, spesso con leggieri parossismi d'intermittentes. Alle volte e 
accompagnata da oppressione al cuore ; alle volte, da coma. 

" La lingua quasi generalmente e sudisia, e peculiarmente di un color cenericio. 
Lo stomacho affetto da nausea, o da vomito. L'escrepone disordinate. 

" In progresso si manifestano i buboni nelle parte glandolose delcorpo; i car- 
bunculi, &c, nei casi piu gravi la prostrazione di forze ; e immediatamente seguita 
dalle petechias, dalli svenementi, e dalla morte. 

"La flessibilita del cadavere nei casi gravi generalmente si osserva; mal'assanza 
di questa apparenza non esclude la peste. 

" L'arte medica ha pochissima influenza nella cura della peste. II medico non 
puo che assistire in parte gli sforzi della natura. La supporazione spontanea del 
bubone puo riguundarsi come la sola crisi della peste. — Campo di Perivoli, 
31 Maggio, 1816." 



APPENDIX, 



327 



trouble nor expense, provided we are enabled to clip the wings and im- 
pede the progress of this destructive demon and relentless enemy. 

The separation of this unfortunate man from the other two persons 
of his family as soon as he began to complain most probably saved 
them. It is possible that they might have escaped even had they all 
remained together, but not at all probable; and therefore the only 
thing that could be done, and the only chance to save them, was to 
separate them from the sick person as soon as possible. 

The following detailed accounts of cases form part of Dr. De 
Georgio's report to me, which is written in Italian. It will be remem- 
bered that this gentleman was employed in attending the plague 
patients from the beginning; and, indeed, was the only one in imme- 
diate attendance on the sick in hospital from the time I took the 
charge, till the malady was finally subdued. The whole of the 
cases here mentioned were his patients. 

His practice, at least, as far as regarded wine, was decidedly the 
Brunonian system; and in the cases which he has detailed, he has 
given the recoveries from extremely unfavourable symptoms, but has 
not mentioned any cases in which the patients died; and it is fair to 
say, that they were by far the most numerous. It would, therefore, 
have been much more satisfactory if he had also given a full account 
of the cases in which the same mode of practice was tried and found 
to be unsuccessful. He has enumerated them in his general return, but 
without going into any detailed account of these cases. Dr. De 
Georgio mentioned to me in reference to his return, that the greater 
part of his papers had been lost or burned in the removal of his hos- 
pital at St. Trinita to that in the camp district, in the confusion 
which took place on that occasion. The cases of recovery, however, 
were preserved by being locked up in his trunk. 

Case XXVII. 

Jan. 4, 1816. Giovanni Vaschi, aged 40, belonging to the Royal 
Corsican Regiment, was attacked with the following symptoms: — 
Headach, staggering, a wild, staring look, foul tongue, vomiting of 
bilious matter, prostration of strength, pulse weak and quick, with 
bubo in the throat. Was ordered an effervescent draught, witli 
twenty drops of laudanum, and an emollient poultice to the bubo. 

z 2 



328 



APPENDIX. 



5th. Nearly the same as yesterday. Rep. omnia, and ordered the 
cinchona mixture, taking one ounce of the powder in the day. 

6th. Delirium has come on, with extreme debility, and a difficulty 
in breathing, ft Alkali volatilis, gtt. xxx. The other medicines to 
be continued, as yesterday. 

In the evening he was ordered the following draught: 
R Spt. vini, ^i. 

Camphor. 3 i. Fiat haust. 

Three blisters, as rubefacients, (come rubifaciente.) 

7th. Nearly as yesterday ; the vomiting has ceased. R Mist. 
cinchona3, et haust. camphor. 

8th. I observed his extremities cold. Rep. omnia ut heri; sinapism 
to the soles of his feet. 

9th. The bubo very much enlarged. The patient can hardly swal- 
low broth; delirium gone. Cont. 

10th. Little alteration from yesterday. Cont. 

1 1th. As yesterday. Cont. 

12th. The bubo burst internally, and a quantity of matter was dis- 
charged; the symptoms much relieved; begins to take some nourish- 
ment and wine; the swelling externally continues very large. 

1 3th. I opened the swelling. 

14th. He was sent to the hospital at Santa Trinita, so that I am 
unable to continue the case any further till the 25th of January, when 
I was put in charge of the hospital, where I found him in a most 
dreadful state, (in pessimo stato,) with a communication betwixt the 
oesophagus and the external aperture, through which a portion of his 
food passed. From this, however, he was perfectly cured by the 
14th of March. 

Case XXVIII. 

Philip Tistling, aged 30, soldier of De Rolle's regiment, was ad 
mitted into the hospital on the 26th of January. The fever was 
ushered in with cold rigors, headach, giddiness, vomiting, pulse inter- 
mitting, stern countenance, tongue foul and dry; is extremely thirsty; 
had been ill for two days before his admission into the hospital; has 
two buboes in the groin, and a carbuncle on the back part of his thigh. 

Took 10 grains of calomel, and in the evening 20 grains of the pulv. 
ipecacuan. comp. Takes no nourishment, except a little wine. Ap- 
plicetur vesicator, bubon et postea cataplasm, emollient. 



APPENDIX. 



329 



Made an incision into the carbuncle in the form of a cross, and 
afterwards dressed it with a mixture of the pulv. cinchonas, camphor, 
and turpentine. 

27th. Delirium has come on. In other respects much as yesterday. 
Ordered the effervescent draught with laudanum; afterwards ordered, 
towards evening, the following mixture — 
ri Camphorse 3L 
Spt. vini ^i. 
Pulv. cinchonae ^ i. 
Alkali volatil. gtt. xx. 
Aquse font tbij. 

Three blisters, as rubefacients. 
28th. In a state of delirium, which returned last night, he escaped 
from the hospital, and bent his way to the village of Argirades, (nearly 
a mile from the hospital, which was established in the convent of Santa 
Trinita.) When the guard acquainted me with his escape, I imme- 
diately sent off the hospital servants to bring him back. Towards 
morning the delirium was somewhat abated. 

R Gum camphorse 3 i. 
Spt. vini ^ i. 
Laudani gtt, xx. 
Pulv. cinchonse ^ij. 
Serpentarise virg. 3 iv. 
Vini lib. ij. tt*l. 
Refuses any kind of food, but drinks wine. 

Continue the poultices to the- buboes, and the dressing to the car- 
buncle. 

29th. The delirium as yesterday, in other respects much the same. 
Cont. 

30th. Little alteration. Cont. 

31st. Speaks sensibly, and the delirium gone, as also the other 
unfavourable symptoms. Cont. 

Feb. 1st. The patient is better. The pulse is natural, but weak. 
Tongue moist and clean, and his eyes no longer' had that stern ap- 
pearance. Took some broth and wine, but refused solid food. Cont. 

2nd. The buboes which at one time looked as if they would come 
to suppuration, seem a little decreased. Appetite still bad. Cont. 

3rd. Much as yesterday. Cont. 

4th. Made an incision in the buboes, and dressed them with digestive, 
(si diede il taglio ai buboni, e medicati col digestive*.) The eschar from 
the carbuncle begins to fall off. 



330 APPENDIX. 

Omitted the mixture with bark, and gave him the decoctum amarum 
and three pints of wine during the day. 
5th. As yesterday. Cont. 
6th. As yesterday. Cont. 

7th. The eschar has fallen off from the carbuncle. Dressed it as a 
simple ulcer. 

From day to day he gained strength, and was dismissed cured on 
the 27th of March. 

Case XXIX. 

Anastasi Marzi, 13 years old, from Argirades, Feb. 3rd, entered 
the hospital of Santa Trinita with symptoms of pyrexia, preceded by 
cold rigors, headach, giddiness, and stern looks. Tongue white, with a 
black streak in the middle, prostration of strength, much thirst, belly 
costive, pulse weak and small, had three carbuncles in his arm, with a 
line of communication between them. 

R Calomel gr. x. 

Made an incision in the form of a cross into the carbuncles, and 
applied the dressing of bark, camphor, and turpentine. Ordered him 
broth and wine. 

Towards evening the calomel had purged him, and he discharged a 
nest of worms (cavo di vermi). Symptoms nearly the same in the 
evening. 

4th. Has vomited a quantity of bilious sordes. Walks like a drunken 
man. Has muttering delirium, thirst, which nothing can quench, and 
stammers in his speech. 

Ordered the effervescent draught with laudanum, also the bark 
mixture, and continued the dressing to the carbuncles as yesterday. 

Towards evening, as the vomiting returned, the effervescent draught 
was repeated. Blisters were applied, (he does not mention where,) 
and sinapisms. 

5th. The vomiting has ceased, but there is an extreme debility and 
difficulty in breathing (anxietate di respirar). The tongue is a little 
cleaner. 

Ordered him a draught with camphor and laudanum, and the dressing 
to the carbuncle. 

6th. This morning the symptoms are milder. The delirium almost 
gone. The pulse still weak, but the difficulty of breathing gone. 



APPENDIX. 



331 



Ordered to take the pulv. cinchonas one ounce in the day. Con- 
tinued the same dressing to the carbuncles, which begin to throw off 
the eschars. He takes two pints of wine, with what nourishment he 
is able. 

7th. He begins to speak plain, and is getting better. Cont. 
8th. Goes on favourably. Cont. 

9th. Pulse natural. Appetite improving, and eyes natural. Cont. 

13th. The eschars have fallen off from the carbuncles, which are 
dressed as common sores. He was cured on the 16th of March. 

Fifty days after his cure, a bubo made its appearance in his groin, 
but without other symptoms of plague, and unaccompanied with fever. 
It came afterwards to suppuration, and healed kindly in a few days. 
I am in doubt whether this was a pestilential bubo or not.* 

Case XXX. 

Feb. 22nd. Spiro Coluri, aged 26, from Argirades, was admitted 
into the hospital, with the following symptoms : headach, giddiness, 
prostration of strength, white tongue, vomiting dark matter, like gru- 
mous blood, pulse scarcely to be felt, with a bubo in the groin, and a 
carbuncle over the pubes. Had been ill for four days before he entered 
the hospital. 

Ordered to take two ounces of the pulv. cinchonas mixed with two 
pints of wine, and to take as much of it as he could. 

Ordered to take 20 drops of the elixir of Paracelsus, to be repeated 
in six hours. A blister was applied to the bubo, and afterwards the 
emollient poultice. 

23rd. (The fifth day of the complaint) the vomiting has stopped, 
and the bubo seems as if it would come to suppuration. Extreme 
debility. Continue the bark, mixture, and poultice. 

24th. Pulse stronger, and the other symptoms diminishing. Wine 
increased to three pints, and what nourishment he can take. 

* His words are : " Dopo cinquanta giorni ch'era guarito, gli comparve un 
bubone all' inguine, ma senza sintomi pestilenziali, e senza febbre ; che venne a 
suppurazione, e guari en pochi giorni. Sono indeciso sequesto era bubone 
pestilenziale, o no." 

I myself remember seeing this boy at the time he had the bubo, and was very 
much struck with the case. The appearances were as the Doctor has briefly related 
them, and the boy got well in a few days. 



83-2 



APPENDIX. 



25th. The patient is better, and the unfavourable symptoms are 
gone off. Opened the bubo. Cont. 

26th. From day to day he got better, and gained strength. He 
was perfectly cured by the 1st of May. 

Case XXXI. 

March 12th. Marina Vlassi, 24 years old, from Critica, was admitted 
into the hospital, with headach, giddiness, tongue foul and yellowish, 
eyes stern, and like glass, muttering delirium, pulse quick and small, 
and scarcely to be felt. Had two carbuncles on her thighs. 

Ordered her one ounce of the pulv. cinchona?, made incisions into 
the carbuncles, and dressed them in the usual manner. Ordered what- 
ever nourishment she could take. 

13th. A state of lethargy has come on, and she seems not to know 
what is going on. Ordered her the camphor draught with 20 drops 
of the volatile alkali. 

14th. Her extremities are cold, in other respects much the same. 
Repr. haust. Sinapisms applied to her feet, and blisters to other parts 
of her body, (it is not mentioned where.) 

15th. Little alteration. Cont. 

1 6th. The lethargic state wearing oif, and she begins to be sensible. 
Cont. She takes the medicines, drinks wine, and her extremities are 
becoming warm. 

17th. She complains grievously of pain and burning heat in the 
carbuncle. Her tongue begins to be clean. 

Ordered her a mixture of one ounce of bark, and two drachms of 
serpentaria, two pints of wine and broth, &c. 

18th. Much as yesterday. Cont. 

19th. She appears better, is gaining strength, and is perfectly sen- 
sible. Cont. Ordered her broth, &c. 

20th. Considerably better; pulse still weak. 

21st. The eschar has fallen off. Cured the 25th of May. 

Case XXXII. 

Vincenzo Morelli, aged 28, one of the felons, March 25th, admitted 
as a hospital patient with pyrexia ; ushered in by previous cold rigors, 



APPENDIX. 



333 



headach, giddiness, foul tongue, vomiting of bilious sordes ; pulse 
weak and frequent, with two inguinal buboes. 

Ordered the effervescent draught, two small blisters to the buboes; 
and after their removal, the emollient poultices. Towards evening 
he was ordered the mist, cinchonas. 

26th. The vomiting continues; eyes sparkling and inflamed; in- 
tolerable thirst; cannot stand erect on his feet; and if he attempts to 
do so, is ready to fall like a drunken man. Complains of a burning 
heat within him; buboes highly inflamed; continue the bark mixture, 
with the addition of a drachm of the serpentaria; continue also the 
effervescent draught, and the poultices to the buboes. Ordered two 
pints of wine and broth. 

27th. Delirium has come on, and he is insensible to what is doing; 
two carbuncles have made their appearance, one on the pubes and 
another on the right eye. 

To the bark mixture is added a drachm of camphor, and twenty 
drops of volatile alkali. Made an incision in the carbuncle on the 
pubes, and dressed it in the usual manner. Washed that on the eye 
with a decoction of bark and a little of the camphorated spirits of 
wine. 

28th. Little alteration. Cont. 
29th. No material alteration. 

30th. Delirium and vomiting gone; is more sensible. On my asking 
him if he knew me, he replied, I know you very well, you are the 
doctor. Fever still continues, but the intense heat, of which he com- 
plained, is gone. He still complains of a throbbing in the buboes, 
and a sensation of burning heat in the carbuncles. The bark mixture 
without the camphor is continued, and also the wine. 

April 1st. Better, but still the febrile symptoms continue. He is 
extremely debilitated, and the buboes are enlarged, but still hard ; 
considerable pain and burning heat in the eye. Cont. 

2nd. Little alteration. Cont. 

3rd. The eschar has begun to come off from the carbuncle in the 
pubes; the buboes seem to be proceeding towards suppuration ; com- 
plains very much of the insupportable pain in his eye. Cont. 

4th. No material alteration. 

5th. The pain of the eye is lessened. Cont. 



334 



APPENDIX. 



6th. The febrile symptoms going off ; the bubo has come to a sup- 
puration ; I opened it, and dressed it with digestive. (He says nothing 
of the other bubo.) 

7th. The carbuncle in the eye begins to discharge a little ichorous 
matter, and small portions of the scab. Cont. 

8th. The patient is getting better, and the sore in the eye begins to 
dry up ; fever entirely gone. Cont. 

He continued to get better ; and by the 25th of May he was per- 
fectly cured ; with the loss, however, of his right eye. 



NOTES. 



Note A, to page 53. 

Among a great variety of plague papers, I find the following letter 
addressed to my late highly valued friend, the late Gen. Sir William 
H. Clinton, in the year 1825, at the time when an abrogation of the 
quarantine laws was seriously pushed forward by the anti-contagionists ; 
and I have reason to believe that it was transmitted to Mr. Peel, 
when Secretary of State for the Home Department. Since that time 
I have not seen sufficiently good reasons to alter my opinion of the 
character of plague as to its being a contagious disease. 

Whether or not this letter had any effect on the question I cannot 
pretend to say, but I did not hear for years afterwards that active steps 
had been taken to repeal the quarantine laws. 

Roedelheim, near Frankfort, April 23rd, 1825. 

My dear General, — I have been favoured with your letter of the 
12th inst., for which accept my best thanks; and I shall lose as little 
time as possible in replying to it. 

Before I received it I had seen in the London newspapers, that it was 
the intention of government to repeal the laws of quarantine. This 
is a grave and important measure, and I earnestly hope, that before 
they decide on such a step, they will have sifted the matter to the 
bottom, and not be led away by any theoretical speculations, however 
specious and plausible they may be; it is practical men whose experi- 
ence and opinions ought to have weight, and not speculative theorists, 
for the plague, both in its character and consequences, is unlike any 
other disease with which we are acquainted. 

My opinion of plague is, that it is a contagious disease — that is, a 
disease capable of being transported from one place to another, not 
only by personal contamination, but also by clothes and other matters ; 



336 



NOTES. 



and I ground this opinion not only on a good deal of consideration of 
the subject, but also from experience in Egypt, and more particularly, 
from that in the late plague in Corfu, on which occasion I was appointed 
superintendent of the plague district of Lefchimo by the late Sir 
Thomas Maitland. 

In this plague, the malady was traced (as clearly as anything of the 
kind could well be,) from its landing by means of smuggled goods at a 
place called the Casa Politi, which goods were brought from the coast 
of Albania, where the plague was raging, to fourteen villages of Lef- 
chimo, constantly following the line of communication: whilst the re- 
maining villages, amounting to thirteen, and which had no intercourse 
with those that were impested, remained free from plague from first to 
last. Now, when I was employed on the spot in investigating this 
subject, which was one of much anxiety to me, I could discover no 
cause, either from locality or other circumstances, why the other vil- 
lages also were not impested, except that they had not had intercourse 
with the plague villages. 

But if I myself had doubts of the contagious nature of the plague, 
the plan of operations which was adopted on that occasion to crush 
and finally to eradicate the malady, and which was completely success- 
ful, would remove those doubts ; that plan was cutting off the commu- 
nication not only betwixt the impested and the healthy part of the 
island, but betwixt the impested and the non-impested villages in the 
district, in addition to separation, segregation, and subsequent purifi- 
cation. It is true, that in more than one instance, the plague started 
in some of the villages where it was supposed to have been got under, 
and when we had no reason to expect such an event; but I am con- 
vinced, from minute inquiry made at the time, that in every instance, 
the misfortune was attributable to a violation of quarantine, either by 
robbing the infected houses, from which the goods had not been re- 
moved, or by clandestine intercourse, which, in almost every instance, 
was satisfactorily proved on the spot at the time, both of which are 
sometimes very difficult, and almost impossible entirely to prevent. 
The disease also several times attacked the troops employed, and was 
traced, even more satisfactorily than amongst the natives, to have been 
owing to the causes mentioned. 

In the plague of Cephalonia, which broke out twice after we had 



NOTES. 



337 



subdued it in Corfu, and were going on with our quarantines, the dis- 
ease was also imported from Albania, by some Greeks who were re- 
turning from thence to join their families, and who had not properly 
purified during the time they were in quarantine, and had concealed some 
articles of wearing apparel which they had brought with them. When 
set at liberty, they went home to their families, where they very shortly 
fell sick, and, as I was informed, two of them died suddenly. The dis- 
ease thus introduced spread quickly amongst these people, and amongst 
others having intercourse with them, and sudden and alarming deaths 
occurred. Here, however, the disease was soon ascertained to be 
plague, which was not the case in that of Corfu. The most prompt 
and vigorous measures were adopted as soon as possible, and the dis- 
ease was put down vi et armis, and has not appeared since. In both 
these instances it appears to me that the plague was imported; at 
least, nothing of the kind was known to exist before the arrival of 
these men, and I confess I am unable in any other way to explain its 
appearance; one thing, however, is I think quite certain, that in both 
these instances, the plague being considered as contagious, was 
effectually put a stop to, and finally extirpated, by acting on that 
principle; and my opinion undoubtedly is, that if it had not been in- 
terfered with, in both cases it w r ould have been more general, 
consequently more fatal, and would not have disappeared so soon. 

In giving you this brief account of the recent plagues in Corfu and 
Cephalonia from my own experience, and the most correct information 
I could gain on the spot, I beg to assure you that I have no favourite 
theory to support, and that I am only actuated by a sense of duty. 

I may add, by the way, that I am convinced the air during the 
prevalence of plague is not contaminated, I mean pestilentially; if that 
had been the case, I think some of the military and medical officers 
employed in these services must have caught the disorder, whereas 
not one of them did; except three medical gentlemen, whose unhappy 
duty it was to attend the plague patients, and all the three died of 
plague before I arrived; whilst I mention this circumstance, I may 
add that another who had the care of the patients in the pest-hospital, 
and was in it night and day, seemed to be absolutely invulnerable to 
the disease, although in constant communication with his patients, and 
remained in health from beginning to end. It will be observed, that 



338 



NOTES. 



I attribute the exemption of the other medical officers, and who were 
stationed among the impested villages, to the carefully avoiding all 
contact either direct or indirect with the impested, and which I have 
no doubt was rigidly attended to. These medical officers amounted 
to thirteen. 

I am not personally acquainted with Dr. McLean, and only know 
him by his writings; but I am of opinion that the causes to which he 
attributes the plague, are in themselves incapable of producing the 
plague, (which, by the way, he himself caught, and by contact too;) if 
they were, I doubt whether we should ever be free of it in some part 
or other of civilized Europe. He seems to me to have gone to inves- 
tigate the nature of plague as a declared anti-contagionist, and to have 
turned every circumstance to the support of that hypothesis. A pest- 
hospital may be a very good place to study the cure of plague, but it 
is hardly the place to ascertain its contagious nature, and much of its 
internal character. 

You will be so good as to observe that what I have said refers en- 
tirely to plague, and not to the yellow fever or other diseases. 

I am not well informed from experience on the state of the quaran- 
tine laws in France and Spain, or indeed throughout Europe, or of 
the mode of purification adopted for goods coming from suspected 
places, but it appears to me that government ought to be well informed 
on these points before they take any decided steps in the important 
measure in question, or before they overturn a system sanctioned for 
some centuries, and on which we lately have had occasion to act, with 
decided benefit to mankind. In thus giving my opinion, I am far 
from thinking that the quarantine laws are perfect; but, on the con- 
trary, they require to be looked into, and I have no doubt may be 
ameliorated; and as the subject is one of vital importance to 
mankind, every part of it ought to be dispassionately and carefully in- 
quired into. 

I should like to see a copy of the Bill for the repeal of the quaran- 
tine laws; perhaps a copy could be sent to me through our Minister at 
Frankfort, who knows my address. I fancy we shall remain here 
about another month, and shall be happy to hear from you. 

I have seen with great pleasure your appointment as Lieutenant- 



NOTES. 



339 



General of the Ordnance, and heartily congratulate you on the same. 
Mrs. White begs to be kindly remembered. Excuse this long, though 
perhaps, at this moment, not uninteresting letter, and 

Believe me to remain, very faithfully yours, 

A. White. 

Lieut.-Gen. Sir William Clinton, M.P., 

Queen Ann-street, Cavendish-square, London. 



Note B, pages 59 — 70. 

I have said elsewhere, that the origin of plague is veiled in impene- 
trable mystery, but that Egypt has been, almost by universal consent, 
considered as its source, and the hot-bed from whence it has pro- 
ceeded ; the grounds on which this opinion has been formed I cannot 
tell ; perhaps it may have reference to the ten plagues mentioned in 
the sacred Scriptures. 

Whilst this work was passing through the press, my attention has 
been called to this subject by an article in the " British and Foreign 
Medical Review" (No. 37,) on Plague, into which this point is intro- 
duced. The article goes on to state that, whenever plague appeared 
in Alexandria, that it has always been traced to come from some vil- 
lages of the Delta ; that in these villages the dead are buried above 
ground, in receptacles which are neither more or less than a cottage 
with one door and no windows ; that in these places the dead are laid 
like herrings in a barrel, &c. 

Now supposing this to be the fact, which I can neither affirm nor 
deny, (never having even heard anything of these receptacles when I 
was in Egypt,) I should think it follows as a matter of course, that 
whenever they are interfered with, plague will make its appearance 
amongst some of the persons employed in burying the dead and 
depositing the bodies there. And is this clearly ascertained to be the 
fact? If it is, then must plague always exist more or less among 
these villages after burials. And is this clearly proved to be the case 
also ? I think I am not assuming too much on this point. 

Were we but perfectly satisfied on these two important points, we 
have grounds for coming to the conclusion that at length this hidden 



340 



NOTES. 



mystery is unveiled, and that the clouds which formerly obscured this 
subject have been dissipated. We may then look forward with some 
confidence to destroy the lion in his den, and thus prevent him after- 
wards from raising up his head; but until then, I fear we cannot 
abrogate the laws of quarantine, although even with our present 
knowledge we may ameliorate and modify them. 

A question has been asked in the same article to which I have 
alluded, Why should Morocco and the Barbary states, where plague 
is never engendered, be debarred from the benefits of free commercial 
intercourse, whilst Algiers enjoys free pratique with Tunis and Tri- 
poli on the one side, and Morocco on the other ? 

Without entering fully into this subject, perhaps I may be per- 
mitted to say that Algiers is now a French colony, and will naturally 
adopt precautionary measures for their own preservation ; that the 
state of warfare in which they have been engaged for several years 
past prevents them in some degree from putting the quarantine laws 
in force. There may have been no plague in these coasts for a length 
of time ; but when we know that the coast of Barbary has been for 
years continuously afflicted with plague, and kept up with extra- 
ordinary mortality, caused, it is probable, by want of purification of 
the impested effects, we ought not, for mere experiment, to do away 
with the laws of health, until we have better grounds for doing so than 
we have at present. 



Note C, page 77. 

It is a curious but important fact, that what I had mentioned rather 
in a speculative way above twenty years ago, when I was composing 
this work, should now literally be fulfilled ; for I have learned from 
unquestionable authority, as well as from written documents, that the 
present enlightened Viceroy has for many years been acting on a 
system of quarantine restraint, with the view of preserving his army 
and navy from plague, but more particularly the latter, in which, per- 
haps, it was more easily to be effected ; and the result has been, what 
indeed might be expected— viz., that he has prevented the malady from 
getting on board his ships of war on occasions when it was making 



NOTES. 



311 



fearful havoc around them. This was particularly the case when 
they were stationed at Alexandria. 



Note D, page 127. 

I am not informed of the mode of purification carried into effect in 
the case of the ship of war L'Eclair, lately arrived from the coast of 
Africa, in which the mortality was so appalling ; but my belief is, that 
if the plan here recommended had been adopted, many valuable lives 
would have been saved. 

I am aware that the malady on board that unfortunate vessel was 
not considered to be the plague, but it was undoubtedly a fever of a 
very malignant character ; yet, nevertheless, although not plague, I 
give it as my opinion, that had the crew and all their effects been 
landed and placed under canvass, or insulated in some way or other 
for a time, the fever would not have been so fatal to both officers and 
men as it was, and many lives might thereby have been spared to the 
country. 



Note E, page 161. 

If these impested things had not been touched, but had been care- 
fully dragged out with the long iron pincers or hooks, exposed to the 
purifying effects of the air for some days, and afterwards to a heat of 
about 60°, I have little doubt but that they would have been perfectly 
disinfected, and thus the lives of these unfortunate persons have been 
saved ; or what would have been attended with still less risk, and have 
been more immediate in its effect, if they had been put into a caldron 
of hot water at once, which would have done no injury to them, not 
only would lives have been saved, but all concerned would have been 
spared the trouble and anxiety of a prolonged period of quarantine 
restraint and the expurgation which was the necessary consequence of 
this sad affair. 



A A 



342 



NOTES. 



Note F, page 272. 

The numerous proclamations sent down to me by government were 
Written in the modern Greek and Italian languages, and are in my 
possession; but being of a local and peculiar character, I have not in- 
serted them, as I was unwilling to enlarge the work unnecessarily — it 
will be seen, too, that I have curtailed both the matter and manage- 
ment, as much as I was able, consistently with the nature of the 
work; but I believe, in doing so, I have not omitted anything essen- 
tially necessary for the elucidation of the subject. 



the end, 



T.Ci Saviil, Printer, 4, Chandos street, Covent Garden. 



